Clinical Characteristics of Healthcare-Associated Pneumonia (HCAP) among Hospitalized Patients in Korean Teaching Hospitals: Multicenter Study
의약학 > 내과학
이종후 , 이재천 , 박혜경 , 전은주 , 최재철 , 김재열 , 김이형 , 전경만 , 서지영 , 김호중
대한결핵 및 호흡기학회
대한결핵및호흡기학회 추계학술발표초록집 2012년, 제114권 232(총1페이지)
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    Background: Healthcare-associated pneumonia (HCAP) is heterogeneous, clinical features and outcomes are different from region to region. And the optimal strategy for treatment of HCAP was controversial among several studies. We aimed to evaluate the clinical features of HCAP patients hospitalized into Korean teaching hospitals. Methods: This study was retrospectively conducted in patients with HCAP or CAP that were hospitalized in four Korean teaching hospitals between December 2008 and January 2011. Results: A total of 858 patients were enrolled and 311 (36.2%) had HCAP. Using the ATS/IDSA guidelines, HCAP patients were divided into two groups; a nursing home acquired pneumonia (NHAP) group (n=59, 18.9%) and a other HCAP group (OHCAP) except NHAP (n=252, 81.0%). Comparing to the CAP group, potentailly drug resistant pathogens were more frequently detected in the HCAP group (2.5% vs. 14.1%; p<0.001) and total in-hospital mortality rate (7.8% vs. 16.3%) were higher in the HCAP group. Otherwise, there were no significant differences in clinical outcomes between the NHAP and the OHCAP group. Multivariable analyses failed to show that the pneumonia type was a prognostic factor for mortality. Only high PSI score was associated with increased mortality (C vs. H, p<0.001 and N vs.O, p<0.001). Conclusions: HCAP should be distinguished from CAP because of different clinical features. However, high mortality in patients with HCAP might not be attributed to a potentially drug resistant pathogens but appears to result from host factors such as age and comorbidities.
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