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Abstract：
BACKGROUND: Community-acquired pneumonia (CAP) represents one of the leading causes of hospitalization and has a substantial impact on the financial burden of healthcare. The aim of this study was to identify factors associated with the length of hospital stay (LOHS), rehospitalization and mortality of patients admitted for CAP.
METHODS: A retrospective cohort study was conducted with patients presenting to a Swiss public hospital between January 2019 and December 2019. Zero-truncated negative binomial and multivariable logistic regression analyses were performed to assess risk factors.
RESULTS: A total of 300 patients were analyzed (median 78 years, IQR [67.56, 85.50] and 53% males) with an average LOHS of 7 days (IQR [5.00, 9.00]). Of the 300 patients, 31.6% (97/300) were re-hospitalized within 6 months, 2.7% (8/300) died within 30 days and 11.7% (35/300) died within 1 year. The results showed that sex (IRR = 0.877, 95% CI = 0.776-0.992, p-value = 0.036), age (IRR = 1.007, 95% CI = 1.002-1.012, p-value = 0.003), qSOFA score (IRR = 1.143, 95% CI = 1.049-1.246, p-value = 0.002) and atypical pneumonia (IRR = 1.357, 95% CI = 1.012-1.819, p-value = 0.04) were predictive of LOHS. Diabetes (OR = 2.149, 95% CI = 1.104-4.172, p-value = 0.024), a higher qSOFA score (OR = 1.958, 95% CI = 1.295-3.002, p-value = 0.002) and rehabilitation after discharge (OR = 2.222, 95% CI = 1.017-4.855, p-value = 0.044) were associated with a higher chance of being re-hospitalized within 6 months, whereas mortality within 30 days and within one year were both associated with older age (OR = 1.248, 95% CI = 1.056-1.562, p-value = 0.026 and OR = 1.073, 95% CI = 1.025-1.132, p-value = 0.005, respectively) and the presence of a cancer diagnosis (OR = 32.671, 95% CI = 4.787-369.1, p-value = 0.001 and OR = 4.408, 95% CI = 1.680-11.43, p-value = 0.002, respectively).
CONCLUSIONS: This study identified routinely available predictors for LOHS, rehospitalization and mortality in patients with CAP, which may further advance our understanding of CAP and thereby improve patient management, discharge planning and hospital costs.
METHODS: A retrospective cohort study was conducted with patients presenting to a Swiss public hospital between January 2019 and December 2019. Zero-truncated negative binomial and multivariable logistic regression analyses were performed to assess risk factors.
RESULTS: A total of 300 patients were analyzed (median 78 years, IQR [67.56, 85.50] and 53% males) with an average LOHS of 7 days (IQR [5.00, 9.00]). Of the 300 patients, 31.6% (97/300) were re-hospitalized within 6 months, 2.7% (8/300) died within 30 days and 11.7% (35/300) died within 1 year. The results showed that sex (IRR = 0.877, 95% CI = 0.776-0.992, p-value = 0.036), age (IRR = 1.007, 95% CI = 1.002-1.012, p-value = 0.003), qSOFA score (IRR = 1.143, 95% CI = 1.049-1.246, p-value = 0.002) and atypical pneumonia (IRR = 1.357, 95% CI = 1.012-1.819, p-value = 0.04) were predictive of LOHS. Diabetes (OR = 2.149, 95% CI = 1.104-4.172, p-value = 0.024), a higher qSOFA score (OR = 1.958, 95% CI = 1.295-3.002, p-value = 0.002) and rehabilitation after discharge (OR = 2.222, 95% CI = 1.017-4.855, p-value = 0.044) were associated with a higher chance of being re-hospitalized within 6 months, whereas mortality within 30 days and within one year were both associated with older age (OR = 1.248, 95% CI = 1.056-1.562, p-value = 0.026 and OR = 1.073, 95% CI = 1.025-1.132, p-value = 0.005, respectively) and the presence of a cancer diagnosis (OR = 32.671, 95% CI = 4.787-369.1, p-value = 0.001 and OR = 4.408, 95% CI = 1.680-11.43, p-value = 0.002, respectively).
CONCLUSIONS: This study identified routinely available predictors for LOHS, rehospitalization and mortality in patients with CAP, which may further advance our understanding of CAP and thereby improve patient management, discharge planning and hospital costs.
摘要：
背景：社区获得性肺炎（CAP）是导致住院的主要原因之一，并对医疗保健的经济负担产生重大影响。这项研究的目的是确定与住院时间（LOHS）相关的因素，因CAP入院的患者的再住院率和死亡率。
方法：对2019年1月至2019年12月期间到瑞士公立医院就诊的患者进行了一项回顾性队列研究。进行零截断负二项和多变量逻辑回归分析以评估危险因素。
结果：共分析了300例患者（中位数为78岁，IQR[67.56，85.50]和53％的男性），平均LOHS为7天（IQR[5.00，9.00]）。在300名患者中，31.6％（97/300）在6个月内再次住院，2.7%（8/300）在30天内死亡，11.7%（35/300）在1年内死亡。结果显示,性别(IRR=0.877,95%CI=0.776-0.992,p值=0.036),年龄(IRR=1.007，95%CI=1.002-1.012，p值=0.003)，qSOFA评分（IRR=1.143，95％CI=1.049-1.246，p值=0.002）和非典型肺炎（IRR=1.357，95％CI=1.012-1.819，p值=0.04）可预测LOHS。糖尿病（OR=2.149，95%CI=1.104-4.172，p值=0.024），较高的qSOFA评分（OR=1.958，95％CI=1.295-3.002，p值=0.002）和出院后康复（OR=2.222，95％CI=1.017-4.855，p值=0.044）与在6个月内再次住院的机会较高相关，而30天内和1年内死亡率均与年龄(OR=1.248,95%CI=1.056-1.562,p值=0.026和OR=1.073,95%CI=1.025-1.132,p值=0.005)和是否存在癌症诊断(OR=32.671,95%CI=4.787-369.1,p值=0.001和OR=4.408-1.68,95%CI=2,p=
结论：这项研究确定了LOHS的常规预测因子，CAP患者的再住院和死亡率，这可以进一步增进我们对CAP的理解，从而改善患者管理，出院计划和住院费用。
方法：对2019年1月至2019年12月期间到瑞士公立医院就诊的患者进行了一项回顾性队列研究。进行零截断负二项和多变量逻辑回归分析以评估危险因素。
结果：共分析了300例患者（中位数为78岁，IQR[67.56，85.50]和53％的男性），平均LOHS为7天（IQR[5.00，9.00]）。在300名患者中，31.6％（97/300）在6个月内再次住院，2.7%（8/300）在30天内死亡，11.7%（35/300）在1年内死亡。结果显示,性别(IRR=0.877,95%CI=0.776-0.992,p值=0.036),年龄(IRR=1.007，95%CI=1.002-1.012，p值=0.003)，qSOFA评分（IRR=1.143，95％CI=1.049-1.246，p值=0.002）和非典型肺炎（IRR=1.357，95％CI=1.012-1.819，p值=0.04）可预测LOHS。糖尿病（OR=2.149，95%CI=1.104-4.172，p值=0.024），较高的qSOFA评分（OR=1.958，95％CI=1.295-3.002，p值=0.002）和出院后康复（OR=2.222，95％CI=1.017-4.855，p值=0.044）与在6个月内再次住院的机会较高相关，而30天内和1年内死亡率均与年龄(OR=1.248,95%CI=1.056-1.562,p值=0.026和OR=1.073,95%CI=1.025-1.132,p值=0.005)和是否存在癌症诊断(OR=32.671,95%CI=4.787-369.1,p值=0.001和OR=4.408-1.68,95%CI=2,p=
结论：这项研究确定了LOHS的常规预测因子，CAP患者的再住院和死亡率，这可以进一步增进我们对CAP的理解，从而改善患者管理，出院计划和住院费用。
