Treatments and outcomes of nursing-home-acquired pneumonia.
BACKGROUND
Bronchopulmonary infections have been considered the leading cause of hospital admissions and death in the nearly 2 million nursing home residents in the United States. Very little is known about the treatments and outcomes of this entity. The purpose of our study was to document the incidence, treatments, and outcomes of nursing-home-acquired pneumonia in hospitalized and nonhospitalized patients.


METHODS
We conducted a retrospective chart review during a 24-month period of patients from two community nursing homes in upstate New York with a total average population of 330 residents. The main outcome measure was 6-week mortality.


RESULTS
Pneumonia was diagnosed in 129 patients, whose overall 6-week mortality rate was 24.8 percent. Ninety-one patients were cared for in the nursing home, and 38 patients were hospitalized. Six-week mortality rate for the nonhospitalized group was 18.7 percent. The hospitalized group's 6-week mortality rate was significantly higher at 39.5 percent. There were no significant differences between the hospitalized and nonhospitalized groups before their diagnosis that predicted outcome.


CONCLUSIONS
For many patients nursing-home-acquired pneumonia can be successfully treated in a nursing home with oral antibiotics at a considerable cost savings when compared with hospitalization.
Thompson
R S
RS
Department of Family Practice, United Health Services Hospitals, Johnson City, New York, USA.
Hall
N K
NK
Szpiech
M
M
Reisenberg
L A
LA
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D015897:Comorbidity; D003428:Cross Infection / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D016013:Likelihood Functions; D008297:Male; D009518:New York / Q000453:epidemiology; D009735:Nursing Homes / Q000706:statistics & numerical data*; D011014:Pneumonia / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D012189:Retrospective Studies; D017741:Survivors / Q000706:statistics & numerical data; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents