title: [Clinical evaluation of bedridden patients with pneumonia receiving home health care].
abstract: Pneumonia which develops in patients while living in their own home is categorized as community-acquired pneumonia (CAP), even if these patients are bedridden and receiving home health care. However, because of the differences in patient backgrounds, we speculated that the clinical outcomes and pathogens of bedridden patients with pneumonia who are receiving home health care would be different from those of CAP. We conducted a prospective study of patients with CAP who were hospitalized at our hospital from April 2007 through September 2009. We compared home health care bedridden pneumonia (performance status 4, PS4-CAP) with non-PS4-CAP in a total of 505 enrolled patients in this study. Among these, 66 had PS4-CAP, mostly associated with aspiration. Severity scores, mortality rate, recurrence rate and length of hospital stay of those with PS4-CAP were significantly higher than those with non-PS4-CAP. Drug resistant pathogens were more frequently isolated from patients with PS4-CAP than from those of non-PS4-CAP. The results of patients with PS4-CAP were in agreement with those of previous health care-associated pneumonia (HCAP) reports. The present study suggested home health care bedridden pneumonia should be categorized as HCAP, not CAP.
authors.affiliation: Department of Respiratory Medicine, Kurashiki Central Hospital.
authors.forename: Hajime
authors.initials: H
authors.lastname: Fukuyama
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ishida
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Tachibana
authors.forename: Chiya
authors.initials: C
authors.lastname: Iga
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nakagawa
authors.forename: Akihiro
authors.initials: A
authors.lastname: Ito
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ubukata
authors.forename: Hiroshige
authors.initials: H
authors.lastname: Yoshioka
authors.forename: Machiko
authors.initials: M
authors.lastname: Arita
authors.forename: Toru
authors.initials: T
authors.lastname: Hashimoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001510:Bed Rest; D017714:Community-Acquired Infections; D004359:Drug Therapy, Combination; D005260:Female; D006699:Home Care Services; D006801:Humans; D007902:Length of Stay; D008297:Male; D011014:Pneumonia / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012720:Severity of Illness Index
chemical_list: D000900:Anti-Bacterial Agents