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Prevalence, Determinants, and Prognostic Significance of Hospital Acquired Pneumonia in Patients with Acute Heart Failure

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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
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.
Type: article
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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