2017 Volume 63 Issue 5 Pages 354-361
Objective: Nursing and healthcare-associated pneumonia (NHCAP) is similar to healthcare-associated pneumonia (HCAP) - a category of pneumonia proposed by the Japanese Respiratory Society (JRS). This study aims to determine the thus far unclear prognostic factors of NHCAP patients, and to clarify the relevance and effectiveness of the selection of antimicrobial agents in accordance with the NHCAP guidelines proposed by the JRS.
Materials: A retrospective observational study of NHCAP patients hospitalized at Juntendo University Shizuoka Hospital between January, 2010 and December, 2012 was undertaken.
Methods: Clinical data were obtained from clinical records, and subjects were assigned to a group which included survived patients at 30 days after admission, and a group which included patients who died within 30 days. The groups were compared regarding baseline characteristics, vital signs, laboratory data, performance status, determination of the severity of the pneumonia (such as with the A-DROP scoring system proposed by the JRS in cases of community-acquired pneumonia), microbiological examinations, and the antimicrobial agents used initially.
Results: 151 NHCAP patients in total were evaluated. A score of 3 or more in the A-DROP scoring system is a factor that has an independent influence on NHCAP patients’ prognoses. There were no statistically significant differences in the use of broad-spectrum antimicrobials between the two groups, even those where the use of broad-spectrum antimicrobials was recommended.
Conclusion: The results suggest that the severity of the pneumonia is an independent prognostic factor of NHCAP patients, for whom using broad-spectrum antimicrobials does not contribute to improving their prognoses.
