Facility characteristics as independent prognostic factors of nursing home-acquired pneumonia

• Published in: The Korean journal of internal medicine Vol. 31; no. 2; pp. 296 - 304
• Main Authors: Lim, Che Wan, Choi, Younghoon, An, Chang Hyeok, Park, Sang Joon, Hwang, Hee-Jin, Chung, Jae Ho, Min, Joo-Won
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Association of Internal Medicine 01.03.2016; 대한내과학회
• Subjects: Aged; Aged, 80 and over; Anti-Bacterial Agents - therapeutic use; Cause of Death; Cross Infection - diagnosis; Cross Infection - drug therapy; Cross Infection - microbiology; Cross Infection - mortality; Female; Homes for the Aged; Hospitals; Humans; Inappropriate Prescribing; Kaplan-Meier Estimate; Male; Nursing Homes; Original; Pneumonia, Bacterial - diagnosis; Pneumonia, Bacterial - drug therapy; Pneumonia, Bacterial - microbiology; Pneumonia, Bacterial - mortality; Proportional Hazards Models; Retrospective Studies; Risk Factors; Time Factors; Treatment Outcome; 내과학; Nursing homes; Pneumonia; Prognosis
• ISSN: 1226-3303; 2005-6648
• DOI: 10.3904/kjim.2014.256

Recently, the incidence of nursing home-acquired pneumonia (NHAP) has been increasing and is now the leading cause of death among nursing home residents. This study was performed to identify risk factors associated with NHAP mortality, focusing on facility characteristics. Data on all patients ≥ 70 years of age admitted with newly diagnosed pneumonia were reviewed. To compare the quality of care in nursing facilities, the following three groups were defined: patients who acquired pneumonia in the community, care homes, and care hospitals. In these patients, 90-day mortality was compared. Survival analyses were performed in 282 patients with pneumonia. In the analyses, 90-day mortality was higher in patients in care homes (12.2%, 40.3%, and 19.6% in community, care homes, and care hospitals, respectively). Among the 118 NHAP patients, residence in a care home, structural lung diseases, treatment with inappropriate antimicrobial agents for accompanying infections, and a high pneumonia severity index score were risk factors associated with higher 90-day mortality. However, infection by potentially drug-resistant pathogens was not important. Unfavorable institutional factors in care homes are important prognostic factors for NHAP.