RESUMEN
Pneumonia is an important infectious entity that affects residents in long-term care facilities (LTCFs), whereas hospitalization-requiring pneumonia (HRP) represents a more critical patient condition with worse outcomes. The evidence addressing the association between Barthel index and risk of HRP among LTCF residents is lacking. A multicenter, retrospective cohort study was conducted in three LTCFs enrolling adult patients who resided for 3 months or more and ever underwent Barthel index evaluation within a study period of January 1 to December 31, 2010. The endpoint was HRP after enrollment. A total of 299 patients (169 women; age, 79.0 ± 12.2 years) were enrolled and categorized into HRP Group (n = 68; 36 women; age, 79.1 ± 11.3 years) and Non-HRP Group (n = 231; 133 women; age, 79.0 ± 12.4 years) by the endpoint. The patients in HRP Group had significantly lower Barthel index (8.6 versus 25.8 points, p < 0.001) but higher proportion of chronic obstructive pulmonary disease (13.2% versus 3.9%, p = 0.004). By the multivariate analysis of logistic regression, we found that lower Barthel index (odds ratio (OR), 0.967; p < 0.001), existence of chronic obstructive pulmonary disease (OR, 4.192; p = 0.015), and feeding route (percutaneous endoscopic gastrostomy comparing with oral feeding; OR, 0.177; p = 0.012) were independently associated with HRP. In conclusion, a lower Barthel index is significantly associated with the occurrence of pneumonia that requires hospitalization in long-term care residents. Barthel index is a useful and reliable tool for risk evaluation in this population.
Asunto(s)
Actividades Cotidianas , Hospitalización/estadística & datos numéricos , Cuidados a Largo Plazo/estadística & datos numéricos , Neumonía/epidemiología , Neumonía/patología , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Métodos de Alimentación , Femenino , Humanos , Modelos Logísticos , Masculino , Estudios Retrospectivos , Taiwán/epidemiologíaRESUMEN
CASE STUDY: Mr Lin, a Chinese man aged 38 years, presented for review of a recent chest X-ray. The X-ray was ordered as part of a pre-employment assessment. He was asymptomatic, a nonsmoker and had no significant past medical history. Full blood examination, lipids, glucose and liver and renal function were normal (also ordered as part of the pre-employment assessment). On examination, he looked well, with blood pressure 134/78 mmHg, heart rate 72/min, and chest and cardiovascular examinations normal.
