1. Difference of health-care associated pneumonia between large hospitals and small hospitals in Japan
- Author
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Yasuyuki Hasegawa, Satoru Katayama, Soichiro Ishikawa, Jun Kurai, Kazuhiko Yoneda, Keji Shigeshiro, Kazuomi Fujise, Tadashi Igishi, Kenichi Takeda, Kazuhiro Kato, Toshiyuki Tatsukawa, Masato Morita, Tatsuya Konishi, Naoto Burioka, Eiji Shimizu, Masanari Watanabe, Akira Yamasaki, Hiroki Chikumi, Hidechika Fujise, Yuji Kawasaki, Ryota Okazaki, Kosuke Yamaguchi, Hiroyuki Yamamoto, Tatsuya Hayabuchi, Yoshisato Tamura, and Yuki Fujise
- Subjects
Male ,medicine.medical_specialty ,Pediatrics ,severity ,Health care associated ,General Biochemistry, Genetics and Molecular Biology ,Japan ,Epidemiology ,medicine ,Humans ,pneumonia ,Aged ,Aged, 80 and over ,Cross Infection ,business.industry ,Mortality rate ,Significant difference ,Retrospective cohort study ,pathogens ,General Medicine ,medicine.disease ,mortality ,Hospitals ,Small hospital ,Pneumonia ,Respiratory failure ,Hospital Bed Capacity ,Emergency medicine ,Female ,business - Abstract
Objective : Health-care associated pneumonia (HCAP) is a new category of pneumonia. We investigated differences of epidemiology, pathogens, and outcomes be- tween HCAP patients in large hospitals and those in small hospitals. Methods : This was a retrospective observational study of patients hospitalized with HCAP from December 2009 to March 2010. HCAP was defined according to ATS/IDSA criteria. A large hospital was defined as 200 beds and a small hospital was 200 beds. Results : Of 117 patients, 61 patients were admitted to large hospitals and 56 patients were admitted to small hospitals. There was a significant difference of HCAP diagnostic criteria between the two groups. The A-DROP severity class was worse in the large hospital group than the small hospital group (P 0.05). Respiratory failure and disturbance of consciousness were more frequent in the large hospital group (P 0.05). The mortality rate was 8.2% n the large hospital group versus 1.8% in the small hospital group. Patients in the very severe A-DROP class had a high mortality rate of 33% in both groups. Conclusion : Patients with severe HCAP were more likely to be admitted to large hospitals. Patients in the very severe A-DROP class should receive intensive antibiotic therapy, but not all patients need broad-spectrum therapy. J. Med. Invest. 58 : 67-74, February, 2011
- Published
- 2011