Title: | Prevalence, Determinants, and Prognostic Significance of Hospital Acquired Pneumonia in Patients with Acute Heart Failure |
Authors: | Tada, Atsushi Browse this author |
Omote, Kazunori Browse this author →KAKEN DB |
Nagai, Toshiyuki Browse this author →KAKEN DB |
Honda, Yasuyuki Browse this author |
Nakano, Hiroki Browse this author |
Honda, Satoshi Browse this author |
Iwakami, Naotsugu Browse this author |
Hamatani, Yasuhiro Browse this author |
Nakai, Michikazu Browse this author |
Nishimura, Kunihiro Browse this author |
Asaumi, Yasuhide Browse this author |
Aiba, Takeshi Browse this author |
Noguchi, Teruo Browse this author |
Kusano, Kengo Browse this author |
Yokoyama, Hiroyuki Browse this author |
Yasuda, Satoshi Browse this author |
Ogawa, Hisao Browse this author |
Anzai, Toshihisa Browse this author →KAKEN DB |
Keywords: | acute heart failure |
hospital-acquired pneumonia |
prognosis |
Issue Date: | Jul-2020 |
Publisher: | MDPI |
Journal Title: | Journal of clinical medicine |
Volume: | 9 |
Issue: | 7 |
Start Page: | 2219 |
Publisher DOI: | 10.3390/jcm9072219 |
Abstract: | The prognostic impact of hospital-acquired pneumonia (HAP) in acute heart failure (AHF) patients have not been fully elucidated. We evaluated 776 consecutive hospitalized AHF patients. The primary in-hospital outcomes were all-cause death and worsening heart failure (WHF), while the outcome following discharge was all-cause death. The clinical diagnosis of HAP was based on clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Patients with HAP had a significantly higher incidence of in-hospital death (12% vs. 1%,p< 0.001), WHF during the hospitalization (28% vs. 7%,p< 0.001), and longer length of hospital stay (p= 0.003) than those without. Among patients who survived at discharge, during a median follow-up period of 741 (interquartile range 422-1000) days, the incidence of all-cause death was significantly higher in patients with HAP than in those without (p< 0.001). In the multivariable Cox regression, HAP development was independently associated with all-cause death after discharge (HR [hazard ratio] 1.86, 95%CI [confidence interval] 1.08-3.19). Furthermore, older age (OR [odds ratio] 1.04, 95%CI 1.01-1.08), male sex (OR 2.21, 95%CI 1.14-4.28), and higher serum white blood cell count (OR 1.18, 95%CI 1.09-1.29) and serum C-reactive protein (OR 1.08, 95%CI 1.01-1.06) were independently associated with HAP development. In hospitalized patients with AHF, HAP development was associated with worse clinical outcomes, suggesting the importance of prevention and early screening for HAP. |
Rights: | http://creativecommons.org/licenses/by/4.0/. |
Type: | article |
URI: | http://hdl.handle.net/2115/79261 |
Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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