AI Article Synopsis
- - The study investigated the incidence and risk factors of hospital-acquired pneumonia (HAP) among older patients (over 65) admitted to a hospital, highlighting a lack of data for those not in intensive care units.
- - Conducted over a year, the study included 1,302 patients and found that while 10.9% had clinically suspected HAP, only 5.8% met the diagnostic criteria, indicating a significant over-diagnosis.
- - The research concluded that HAP is prevalent among older hospital patients but often misdiagnosed due to insufficient clinical evidence in many cases.
Article Abstract
Background: hospital-acquired pneumonia poses a hazard to older people who are hospitalised, yet few data exist on the incidence or risk factors in non-intensive care patients. This study aimed to determine the incidence of hospital-acquired pneumonia (HAP) in a sample of hospitalised older people.
Methods: prospective survey of hospitalised older patients (>65 years) at a single centre over a 12-month period. Casenote and chart data were collected on acute medical, orthopaedic and Medicine for the Elderly wards. HAP was defined in accordance with the European and Scottish National Prevalence Survey 2011 definition. Key analyses were incidence of clinically suspected and case definition clinically confirmed HAP.
Results: one thousand three hundred and two patients were included in the analysis. Five hundred and thirty-nine (41%) were male; mean age was 82 years (SD 8). Median length of hospital stay was 14 days (IQR 20). One hundred and fifty-seven episodes of HAP were clinically suspected in 143 patients (10.9% of admissions), but only 83 episodes in 76 patients met the diagnostic criteria (5.8% of admissions). The risk of HAP was 0.3% per day in hospital. Reasons for failure to meet the diagnostic criteria in 75 cases were lack of radiographic evidence in 60/75; lack of evidence of inflammation in 42/75, and lack of respiratory signs or symptoms in 13/75; 35/75 (47%) of cases lacked evidence in two or more domains.
Conclusion: HAP is common but over-diagnosed in older hospitalised patients.
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| http://dx.doi.org/10.1093/ageing/afv168 | DOI Listing |
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