Physical Training During Hospital Admission With Community-Acquired Pneumonia

Author(s):  
2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wenfang Guo ◽  
Letai Yi ◽  
Peng Wang ◽  
Baojun Wang ◽  
Minhui Li

AbstractThe relationship between air temperature and the hospital admission of adult patients with community-acquired pneumonia (CAP) was analyzed. The hospitalization data pertaining to adult CAP patients (age ≥ 18 years) in two tertiary comprehensive hospitals in Baotou, Inner Mongolia Autonomous Region, China from 2014 to 2018 and meteorological data there in the corresponding period were collected. The exposure–response relationship between the daily average temperature and the hospital admission of adult CAP patients was quantified by using a distributed lag non-linear model. A total of 4466 cases of adult patients with CAP were admitted. After eliminating some confounding factors such as relative humidity, wind speed, air pressure, long-term trend, and seasonal trend, a lower temperature was found to be associated with a higher risk of adult CAP. Compared to 21 °C, lower temperature range of 4 to –12 °C was associated with a greater number of CAP hospitalizations among those aged ≥ 65 years, and the highest relative risk (RR) was 2.80 (95% CI 1.15–6.80) at a temperature of − 10 °C. For those < 65 years, lower temperature was not related to CAP hospitalizations. Cumulative lag RRs of low temperature with CAP hospitalizations indicate that the risk associated with colder temperatures appeared at a lag of 0–7 days. For those ≥ 65 years, the cumulative RR of CAP hospitalizations over lagging days 0–5 was 1.89 (95% CI 1.01–3. 56). In brief, the lower temperature had age-specific effects on CAP hospitalizations in Baotou, China, especially among those aged ≥ 65 years.


2007 ◽  
Vol 51 (10) ◽  
pp. 3568-3573 ◽  
Author(s):  
Scott T. Micek ◽  
Katherine E. Kollef ◽  
Richard M. Reichley ◽  
Nareg Roubinian ◽  
Marin H. Kollef

ABSTRACT Pneumonia occurring outside of the hospital setting has traditionally been categorized as community-acquired pneumonia (CAP). However, when pneumonia is associated with health care risk factors (prior hospitalization, dialysis, residing in a nursing home, immunocompromised state), it is now more appropriately classified as a health care-associated pneumonia (HCAP). The relative incidences of CAP and HCAP among patients requiring hospital admission is not well described. The objective of this retrospective cohort study, involving 639 patients with culture-positive CAP and HCAP admitted between 1 January 2003 and 31 December 2005, was to characterize the incidences, microbiology, and treatment patterns for CAP and HCAP among patients requiring hospital admission. HCAP was more common than CAP (67.4% versus 32.6%). The most common pathogens identified overall included methicillin-resistant Staphylococcus aureus (24.6%), Streptococcus pneumoniae (20.3%), Pseudomonas aeruginosa (18.8%), methicillin-sensitive Staphylococcus aureus (13.8%), and Haemophilus influenzae (8.5%). The hospital mortality rate was statistically greater among patients with HCAP than among those with CAP (24.6% versus 9.1%; P < 0.001). Administration of inappropriate initial antimicrobial treatment was statistically more common among HCAP patients (28.3% versus 13.0%; P < 0.001) and was identified as an independent risk factor for hospital mortality. Our study found that the incidence of HCAP was greater than that of CAP among patients with culture-positive pneumonia requiring hospitalization at Barnes-Jewish Hospital. Patients with HCAP were more likely to initially receive inappropriate antimicrobial treatment and had a greater risk of hospital mortality. Health care providers should differentiate patients with HCAP from those with CAP in order to provide more appropriate initial antimicrobial therapy.


2006 ◽  
Vol 135 (2) ◽  
pp. 262-269 ◽  
Author(s):  
J. E. CLARK ◽  
D. HAMMAL ◽  
F. HAMPTON ◽  
D. SPENCER ◽  
L. PARKER

There is little UK data on hospital admission rates for childhood pneumonia, lobar pneumonia, severity or risk factors. From 13 hospitals serving the catchment population, demographic and clinical details were prospectively collected between 2001 and 2002 for children aged 0–15 years, seen by a paediatrician with community-acquired pneumonia (CAP) and consistent chest X-ray changes. From 750 children assessed in hospital, incidence of CAP was 14·4 (95% CI 13·4–15·4)/10000 children per year and 33·8 (95% CI 31·1–36·7) for <5-year-olds; with an incidence for admission to hospital of 12·2 (95% CI 11·3–13·2) and 28·7 (95% CI 26·2–31·4) respectively. Where ascertainment was confirmed, incidence of CAP assessed in hospital was 16·1 (95% CI 14·9–17·3) and 41·0 (95% CI 37·7–44·5) in the 0–4 years age group, whilst incidence for hospital admission was 13·5 (95% CI 12·4–14·6) and 32 (95% CI 29·1–35·1) respectively. In the <5 years age group incidence of lobar pneumonia was 5·6 (95% CI 4·5–6·8)/10000 per year and severe disease 19·4 (95% CI 17·4–21·7)/10000 per year. Risk of severe CAP was significantly increased for those aged <5 years (OR 1·50, 95% CI 1·07–2·11) and with prematurity, OR 4·02 (95% CI 1·16–13·85). It also varied significantly by county of residence. This is a unique insight into the burden of hospital assessments and admissions caused by childhood pneumonia in the United Kingdom and will help inform future preventative strategies.


2019 ◽  
Vol 45 (4) ◽  
Author(s):  
Evrim Eylem Akpınar ◽  
Derya Hoşgün ◽  
Serdar Akpınar ◽  
Can Ateş ◽  
Ayşe Baha ◽  
...  

ABSTRACT Objective: Pneumonia is a leading cause of mortality worldwide, especially in the elderly. The use of clinical risk scores to determine prognosis is complex and therefore leads to errors in clinical practice. Pneumonia can cause increases in the levels of cardiac biomarkers such as N-terminal pro-brain natriuretic peptide (NT-proBNP). The prognostic role of the NT-proBNP level in community acquired pneumonia (CAP) remains unclear. The aim of this study was to evaluate the prognostic role of the NT-proBNP level in patients with CAP, as well as its correlation with clinical risk scores. Methods: Consecutive inpatients with CAP were enrolled in the study. At hospital admission, venous blood samples were collected for the evaluation of NT-proBNP levels. The Pneumonia Severity Index (PSI) and the Confusion, Urea, Respiratory rate, Blood pressure, and age ≥ 65 years (CURB-65) score were calculated. The primary outcome of interest was all-cause mortality within the first 30 days after hospital admission, and a secondary outcome was ICU admission. Results: The NT-proBNP level was one of the best predictors of 30-day mortality, with an area under the curve (AUC) of 0.735 (95% CI: 0.642-0.828; p < 0.001), as was the PSI, which had an AUC of 0.739 (95% CI: 0.634-0.843; p < 0.001), whereas the CURB-65 had an AUC of only 0.659 (95% CI: 0.556-0.763; p = 0.006). The NT-proBNP cut-off level found to be the best predictor of ICU admission and 30-day mortality was 1,434.5 pg/mL. Conclusions: The NT-proBNP level appears to be a good predictor of ICU admission and 30-day mortality among inpatients with CAP, with a predictive value for mortality comparable to that of the PSI and better than that of the CURB-65 score.


Author(s):  
Jose N. Sancho-Chust ◽  
Eusebi Chiner ◽  
Jose Blanquer ◽  
Francisco Sanz ◽  
Estrella Fernandez-Fabrellas ◽  
...  

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