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

Hao Chen,1 Yu Hara,1 Nobuyuki Horita,1 Yusuke Saigusa,2 Yoshihiro Hirai,3 Takeshi Kaneko1 1Department of Respiratory Medicine, Yokohama City University Hospital, Kanazawa, Yokohama 236-0004, Japan; 2Department of Biostatistics, Yokohama City University Hospital, Kanazawa, Yokohama 236-0004, Japan; 3...

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Autores principales:	Chen H, Hara Y, Horita N, Saigusa Y, Hirai Y, Kaneko T
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	community-acquired pneumonia functional status patient discharge rehabilitation senior Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/4a8288dce25e4b4089f2fb3cfaee6794
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spelling	oai:doaj.org-article:4a8288dce25e4b4089f2fb3cfaee67942021-12-02T12:34:05ZDeclined Functional Status Prolonged Hospital Stay for Community-Acquired Pneumonia in Seniors1178-1998https://doaj.org/article/4a8288dce25e4b4089f2fb3cfaee67942020-08-01T00:00:00Zhttps://www.dovepress.com/declined-functional-status-prolonged-hospital-stay-for-community-acqui-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Hao Chen,1 Yu Hara,1 Nobuyuki Horita,1 Yusuke Saigusa,2 Yoshihiro Hirai,3 Takeshi Kaneko1 1Department of Respiratory Medicine, Yokohama City University Hospital, Kanazawa, Yokohama 236-0004, Japan; 2Department of Biostatistics, Yokohama City University Hospital, Kanazawa, Yokohama 236-0004, Japan; 3Department of Respiratory Medicine, Kanto Rosai Hospital, Kawasaki 211-8510, JapanCorrespondence: Hao ChenDepartment of Respiratory Medicine, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa, Yokohama 236-0004, JapanTel +81 45-352-7962Fax +81 45-352-7963Email chinksmd@yahoo.co.jpPurpose: 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.Keywords: community-acquired pneumonia, functional status, patient discharge, rehabilitation, seniorChen HHara YHorita NSaigusa YHirai YKaneko TDove Medical Pressarticlecommunity-acquired pneumoniafunctional statuspatient dischargerehabilitationseniorGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 15, Pp 1513-1519 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	community-acquired pneumonia functional status patient discharge rehabilitation senior Geriatrics RC952-954.6
spellingShingle	community-acquired pneumonia functional status patient discharge rehabilitation senior Geriatrics RC952-954.6 Chen H Hara Y Horita N Saigusa Y Hirai Y Kaneko T Declined Functional Status Prolonged Hospital Stay for Community-Acquired Pneumonia in Seniors
description	Hao Chen,1 Yu Hara,1 Nobuyuki Horita,1 Yusuke Saigusa,2 Yoshihiro Hirai,3 Takeshi Kaneko1 1Department of Respiratory Medicine, Yokohama City University Hospital, Kanazawa, Yokohama 236-0004, Japan; 2Department of Biostatistics, Yokohama City University Hospital, Kanazawa, Yokohama 236-0004, Japan; 3Department of Respiratory Medicine, Kanto Rosai Hospital, Kawasaki 211-8510, JapanCorrespondence: Hao ChenDepartment of Respiratory Medicine, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa, Yokohama 236-0004, JapanTel +81 45-352-7962Fax +81 45-352-7963Email chinksmd@yahoo.co.jpPurpose: 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.Keywords: community-acquired pneumonia, functional status, patient discharge, rehabilitation, senior
format	article
author	Chen H Hara Y Horita N Saigusa Y Hirai Y Kaneko T
author_facet	Chen H Hara Y Horita N Saigusa Y Hirai Y Kaneko T
author_sort	Chen H
title	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_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_sort	declined functional status prolonged hospital stay for community-acquired pneumonia in seniors
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/4a8288dce25e4b4089f2fb3cfaee6794
work_keys_str_mv	AT chenh declinedfunctionalstatusprolongedhospitalstayforcommunityacquiredpneumoniainseniors AT haray declinedfunctionalstatusprolongedhospitalstayforcommunityacquiredpneumoniainseniors AT horitan declinedfunctionalstatusprolongedhospitalstayforcommunityacquiredpneumoniainseniors AT saigusay declinedfunctionalstatusprolongedhospitalstayforcommunityacquiredpneumoniainseniors AT hiraiy declinedfunctionalstatusprolongedhospitalstayforcommunityacquiredpneumoniainseniors AT kanekot declinedfunctionalstatusprolongedhospitalstayforcommunityacquiredpneumoniainseniors
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Declined Functional Status Prolonged Hospital Stay for Community-Acquired Pneumonia in Seniors

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