title: Changes in physical function after hospitalization in patients with nursing and healthcare-associated pneumonia.
abstract: To clarify the functional changes after hospitalization due to pneumonia in elderly Japanese patients, we investigated the changes in physical functioning, nutritional routes, and diet that occurred after hospitalization in patients with nursing and healthcare-associated pneumonia (NHCAP). We analyzed 405 patients with NHCAP and compared findings with 448 patients with community-acquired pneumonia (CAP). Among the NHCAP patients, 140 (34%) patients showed a decline in activities of daily living function between baseline and discharge. After hospital discharge, 149 (37%) NHCAP patients did not return to the same residence location compared with where they were living prior to hospital admission. The frequency of this outcome was significantly higher in NHCAP patients than in CAP patients (p < 0.0001). After 6 months' follow-up, of the patients who transferred to different hospitals, 41 (73%) patients with CAP had returned to their own home, but only 16 (20%) patients with NHCAP could return home (p < 0.0001). Rates of alteration of nutritional route and type of diet from oral nutrition were significantly higher in NHCAP patients compared with CAP patients (22% vs 4%, p < 0.0001). Our results demonstrated that approximately one-third of hospitalized patients with NHCAP showed a decline in physical function. In addition, approximately one-fifth of NHCAP patients had changed their route of nutrition and type of diet. Our results indicated that physicians should attach greater importance to preventative measures against NHCAP rather than relying on antibiotic therapy post-infection in the management of pneumonia in elderly patients in order to extend their healthy life expectancy.
authors: Department of Internal Medicine I, Kawasaki Medical School, Okayama, Japan.
authors: Tadashi
authors: T
authors: Kato
authors: Department of Internal Medicine I, Kawasaki Medical School, Okayama, Japan. Electronic address: nao@med.kawasaki-m.ac.jp.
authors: Naoyuki
authors: N
authors: Miyashita
authors: Department of Internal Medicine I, Kawasaki Medical School, Okayama, Japan.
authors: Yasuhiro
authors: Y
authors: Kawai
authors: Department of Pulmonology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan.
authors: Nobuyuki
authors: N
authors: Horita
authors: Department of Internal Medicine I, Kawasaki Medical School, Okayama, Japan.
authors: Shoichiro
authors: S
authors: Yano
authors: Department of Internal Medicine I, Kawasaki Medical School, Okayama, Japan.
authors: Yuko
authors: Y
authors: Oka
authors: Department of Internal Medicine I, Kawasaki Medical School, Okayama, Japan.
authors: Takashi
authors: T
authors: Oda
authors: Department of Internal Medicine I, Kawasaki Medical School, Okayama, Japan.
authors: Niro
authors: N
authors: Okimoto
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000503:physiopathology*; D003428:Cross Infection / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D010343:Patient Admission; D011014:Pneumonia / Q000503:physiopathology*
keywords: Community-acquired pneumonia; Extended healthy life expectancy; Functional change; Nursing and healthcare-associated pneumonia; Pneumococcal vaccination