临床定义的吸入性肺炎是一种与长期住院相关的独立风险因素:一项前性队列研究
Takao Wakabayashi1,2, Sugihiro Hamaguchi3,4, Konosuke Morimoto5
1Department of General and Emergency Medicine, Japan Community Healthcare Organization Sapporo Hokushin Hospital, 2-1,2-Jo,6-Chome, Atsubetsu-Cho, Atsubetsu-Ku, Sapporo, 004-8618, Japan.
临床定义的吸入性肺炎与老年患者的住院时间更长有关. 这一发现表明,对于肺炎患者的口腔喉功能障碍,可能需要定制的康复策略.
科学领域:
- 老年医学 老年医学
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
背景情况:
- 老年肺炎患者的长期住院往往导致功能衰退.
- 吸气性肺炎是老年患者的一个重要亚型,由于潜在的口腔关功能障碍,经常在临床上诊断出.
- 吸入性肺炎和长时间住院之间的直接联系,独立于一般功能下降,需要澄清.
研究的目的:
- 确定临床定义的吸入性肺炎本身是否与长期住院有关.
- 调查导致老年肺炎患者住院时间延长的因素.
主要方法:
- 一项前性观察性研究包括2,795名患有社区获得性肺炎 (CAP) 或与医疗保健相关的肺炎 (HCAP) 的患者.
- 吸收性肺炎在临床上是基于记录的吸收或口腔关功能障碍 (例如,意识/神经肌肉疾病) 定义的.
- 后勤回归分析了吸气性肺炎和长期住院 (定义为≥30天) 之间的关联,并调整了诸如年龄,并发病症和CURB得分等混因素.
主要成果:
- 在31.4% (878/2,795) 的患者中发现了吸气性肺炎.
- 临床定义的吸气性肺炎独立与长期住院相关 (调整后的几率比1.44;p<0.01).
- 长期停留的其他重要因素包括较高的年龄,男性性别,HCAP,高CURB得分,低BMI,心力衰竭,脑血管疾病和抗精神病药物的使用.
结论:
- 临床定义的吸入性肺炎是长时间住院治疗的独立风险因素.
- 这种关联凸显了对肺炎患者具有口腔关功能障碍的特殊康复干预措施的需要.
- 了解这些联系可以改善患者管理,减少住院期间和之后的功能衰退.
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