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Declined Functional Status Prolonged Hospital Stay for Community-Acquired Pneumonia in Seniors

PURPOSE: Among senior community-acquired pneumonia (CAP) survivors, functional status after hospitalization is often decreased. This study investigated the change of functional status affecting delayed discharge. PATIENTS AND METHODS: This retrospective observational study was conducted in two medic...

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Autores principales: Chen, Hao, Hara, Yu, Horita, Nobuyuki, Saigusa, Yusuke, Hirai, Yoshihiro, Kaneko, Takeshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468580/
https://www.ncbi.nlm.nih.gov/pubmed/32943854
http://dx.doi.org/10.2147/CIA.S267349
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author Chen, Hao
Hara, Yu
Horita, Nobuyuki
Saigusa, Yusuke
Hirai, Yoshihiro
Kaneko, Takeshi
author_facet Chen, Hao
Hara, Yu
Horita, Nobuyuki
Saigusa, Yusuke
Hirai, Yoshihiro
Kaneko, Takeshi
author_sort Chen, Hao
collection PubMed
description PURPOSE: Among senior community-acquired pneumonia (CAP) survivors, functional status after hospitalization is often decreased. This study investigated the change of functional status affecting delayed discharge. PATIENTS AND METHODS: This retrospective observational study was conducted in two medical facilities from January 2016 to December 2018. Hospitalized CAP patients >64 years old were divided into two groups: an early group discharged ≤1 week after ending antibiotic treatment and a delayed group discharged >1 week after ending antibiotic treatment. The primary outcome was decline in functional status. RESULTS: The early group comprised 170 patients and the delayed group comprised 155 patients (median age: 78 vs 82 years; p = 0.007). Distribution of the causative microorganisms and initial prescription of antibiotics showed no significant differences in the two groups (p=0.38; p=0.83, respectively) More patients showed decline in functional status in the delayed group than the early group (16 (9.4%) vs 49 (31.6%), p<0.001), even if rehabilitation was more frequently conducted (77 (45.3%) vs 118 (76.1%); p<0.001). Higher medical expenses were observed in the delayed group ($8631 vs $3817, respectively; p<0.001). Multivariable regression analysis of factors contributing delayed discharge revealed that decreased functional status, pneumonia severity index (PSI) categories, rehabilitation enrolled, aspiration and age were independently associated with delayed discharge (odds ratio 4.31, 95% confidence interval (CI) 2.32–7.98; 2.34, 95% CI 1.43–3.82; 15.96, 95% CI 4.56–55.82 (PSI V vs II); 2.48, 95% CI 1.11–5.98; and 1.03, 95% CI 1.01–1.06; respectively). CONCLUSION: Functional status decline was independently associated with extended hospitalization.
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spelling pubmed-74685802020-09-16 Declined Functional Status Prolonged Hospital Stay for Community-Acquired Pneumonia in Seniors Chen, Hao Hara, Yu Horita, Nobuyuki Saigusa, Yusuke Hirai, Yoshihiro Kaneko, Takeshi Clin Interv Aging Original Research PURPOSE: Among senior community-acquired pneumonia (CAP) survivors, functional status after hospitalization is often decreased. This study investigated the change of functional status affecting delayed discharge. PATIENTS AND METHODS: This retrospective observational study was conducted in two medical facilities from January 2016 to December 2018. Hospitalized CAP patients >64 years old were divided into two groups: an early group discharged ≤1 week after ending antibiotic treatment and a delayed group discharged >1 week after ending antibiotic treatment. The primary outcome was decline in functional status. RESULTS: The early group comprised 170 patients and the delayed group comprised 155 patients (median age: 78 vs 82 years; p = 0.007). Distribution of the causative microorganisms and initial prescription of antibiotics showed no significant differences in the two groups (p=0.38; p=0.83, respectively) More patients showed decline in functional status in the delayed group than the early group (16 (9.4%) vs 49 (31.6%), p<0.001), even if rehabilitation was more frequently conducted (77 (45.3%) vs 118 (76.1%); p<0.001). Higher medical expenses were observed in the delayed group ($8631 vs $3817, respectively; p<0.001). Multivariable regression analysis of factors contributing delayed discharge revealed that decreased functional status, pneumonia severity index (PSI) categories, rehabilitation enrolled, aspiration and age were independently associated with delayed discharge (odds ratio 4.31, 95% confidence interval (CI) 2.32–7.98; 2.34, 95% CI 1.43–3.82; 15.96, 95% CI 4.56–55.82 (PSI V vs II); 2.48, 95% CI 1.11–5.98; and 1.03, 95% CI 1.01–1.06; respectively). CONCLUSION: Functional status decline was independently associated with extended hospitalization. Dove 2020-08-27 /pmc/articles/PMC7468580/ /pubmed/32943854 http://dx.doi.org/10.2147/CIA.S267349 Text en © 2020 Chen et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Chen, Hao
Hara, Yu
Horita, Nobuyuki
Saigusa, Yusuke
Hirai, Yoshihiro
Kaneko, Takeshi
Declined Functional Status Prolonged Hospital Stay for Community-Acquired Pneumonia in Seniors
title Declined Functional Status Prolonged Hospital Stay for Community-Acquired Pneumonia in Seniors
title_full Declined Functional Status Prolonged Hospital Stay for Community-Acquired Pneumonia in Seniors
title_fullStr Declined Functional Status Prolonged Hospital Stay for Community-Acquired Pneumonia in Seniors
title_full_unstemmed Declined Functional Status Prolonged Hospital Stay for Community-Acquired Pneumonia in Seniors
title_short Declined Functional Status Prolonged Hospital Stay for Community-Acquired Pneumonia in Seniors
title_sort declined functional status prolonged hospital stay for community-acquired pneumonia in seniors
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468580/
https://www.ncbi.nlm.nih.gov/pubmed/32943854
http://dx.doi.org/10.2147/CIA.S267349
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