1 resultado para Nursing homes and assisted living facilities
em Repositório do Centro Hospitalar de Lisboa Central, EPE - Centro Hospitalar de Lisboa Central, EPE, Portugal
Filtro por publicador
- Repository Napier (3)
- University of Cagliari UniCA Eprints (1)
- Abertay Research Collections - Abertay University’s repository (1)
- Aberystwyth University Repository - Reino Unido (2)
- Academic Archive On-line (Jönköping University; Sweden) (2)
- Academic Archive On-line (Karlstad University; Sweden) (2)
- Academic Research Repository at Institute of Developing Economies (1)
- Applied Math and Science Education Repository - Washington - USA (1)
- Aquatic Commons (9)
- Archive of European Integration (3)
- Archivo Digital para la Docencia y la Investigación - Repositorio Institucional de la Universidad del País Vasco (5)
- Aston University Research Archive (2)
- Biblioteca Digital da Produção Intelectual da Universidade de São Paulo (10)
- Biblioteca Digital da Produção Intelectual da Universidade de São Paulo (BDPI/USP) (2)
- Biblioteca Digital de Teses e Dissertações Eletrônicas da UERJ (12)
- BORIS: Bern Open Repository and Information System - Berna - Suiça (19)
- Brock University, Canada (2)
- Bucknell University Digital Commons - Pensilvania - USA (13)
- CentAUR: Central Archive University of Reading - UK (17)
- Center for Jewish History Digital Collections (2)
- Chinese Academy of Sciences Institutional Repositories Grid Portal (3)
- Cochin University of Science & Technology (CUSAT), India (1)
- Comissão Econômica para a América Latina e o Caribe (CEPAL) (2)
- CORA - Cork Open Research Archive - University College Cork - Ireland (7)
- Dalarna University College Electronic Archive (6)
- Deakin Research Online - Australia (92)
- Digital Archives@Colby (1)
- Digital Commons - Michigan Tech (1)
- Digital Commons - Montana Tech (1)
- Digital Commons at Florida International University (11)
- DigitalCommons@The Texas Medical Center (13)
- Doria (National Library of Finland DSpace Services) - National Library of Finland, Finland (1)
- DRUM (Digital Repository at the University of Maryland) (1)
- Duke University (3)
- eResearch Archive - Queensland Department of Agriculture; Fisheries and Forestry (3)
- Escola Superior de Educação de Paula Frassinetti (1)
- FUNDAJ - Fundação Joaquim Nabuco (1)
- Greenwich Academic Literature Archive - UK (8)
- Harvard University (2)
- Helda - Digital Repository of University of Helsinki (16)
- Illinois Digital Environment for Access to Learning and Scholarship Repository (2)
- Instituto Nacional de Saúde de Portugal (1)
- Instituto Politécnico de Bragança (1)
- Instituto Politécnico de Viseu (2)
- Instituto Politécnico do Porto, Portugal (2)
- Iowa Publications Online (IPO) - State Library, State of Iowa (Iowa), United States (88)
- Lume - Repositório Digital da Universidade Federal do Rio Grande do Sul (1)
- Memorial University Research Repository (2)
- National Center for Biotechnology Information - NCBI (1)
- Nottingham eTheses (1)
- Plymouth Marine Science Electronic Archive (PlyMSEA) (3)
- Portal de Revistas Científicas Complutenses - Espanha (2)
- Publishing Network for Geoscientific & Environmental Data (3)
- QUB Research Portal - Research Directory and Institutional Repository for Queen's University Belfast (152)
- Queensland University of Technology - ePrints Archive (211)
- RCAAP - Repositório Científico de Acesso Aberto de Portugal (4)
- ReCiL - Repositório Científico Lusófona - Grupo Lusófona, Portugal (3)
- REPOSITÓRIO ABERTO do Instituto Superior Miguel Torga - Portugal (1)
- Repositorio Académico de la Universidad Nacional de Costa Rica (1)
- Repositório Científico da Escola Superior de Enfermagem de Coimbra (3)
- Repositório Científico da Universidade de Évora - Portugal (4)
- Repositório do Centro Hospitalar de Lisboa Central, EPE - Centro Hospitalar de Lisboa Central, EPE, Portugal (1)
- Repositório Institucional da Universidade de Aveiro - Portugal (2)
- Repositorio Institucional de la Universidad de Málaga (2)
- Repositório Institucional UNESP - Universidade Estadual Paulista "Julio de Mesquita Filho" (11)
- Research Open Access Repository of the University of East London. (1)
- RUN (Repositório da Universidade Nova de Lisboa) - FCT (Faculdade de Cienecias e Technologia), Universidade Nova de Lisboa (UNL), Portugal (2)
- SAPIENTIA - Universidade do Algarve - Portugal (1)
- SerWisS - Server für Wissenschaftliche Schriften der Fachhochschule Hannover (1)
- South Carolina State Documents Depository (1)
- Universidad de Alicante (4)
- Universidad del Rosario, Colombia (1)
- Universidad Politécnica de Madrid (10)
- Universidade Católica Portuguesa (1)
- Universidade de Lisboa - Repositório Aberto (3)
- Universidade Federal do Pará (1)
- Universidade Federal do Rio Grande do Norte (UFRN) (1)
- Universidade Técnica de Lisboa (1)
- Universitätsbibliothek Kassel, Universität Kassel, Germany (1)
- Université de Lausanne, Switzerland (5)
- Université de Montréal, Canada (5)
- University of Connecticut - USA (1)
- University of Michigan (101)
- University of Queensland eSpace - Australia (14)
- University of Washington (1)
- WestminsterResearch - UK (3)
- Worcester Research and Publications - Worcester Research and Publications - UK (3)
Resumo:
Nursing home-acquired pneumonia (NHAP) is one of the most common infections arising amongst nursing home residents, and its incidence is expected to increase as population ages. The NHAP recommendation for empiric broad-spectrum antibiotic therapy, arising from the concept of healthcare-associated pneumonia, has been challenged by recent studies reporting low rates of multidrug-resistant (MDR) bacteria. This single center study analyzes the results of NHAP patients admitted through the Emergency Department (ED) at a tertiary center during the year 2010. There were 116 cases, male gender corresponded to 34.5 % of patients and median age was 84 years old (IQR 77-90). Comorbidities were present in 69.8 % of cases and 48.3 % of patients had used healthcare services during the previous 90 days. In-hospital mortality rate was 46.6 % and median length-of-stay was 9 days. Severity assessment at the Emergency Department provided CURB65 index score and respective mortality (%) results: zero: n = 0; one: n = 7 (0 %); two: n = 18 (38.9 %); three: n = 26 (38.5 %); four: n = 30 (53.3 %); and five; n = 22 (68.2 %); and sepsis n = 50 (34.0 %), severe sepsis n = 43 (48.8 %) and septic shock n = 22 (72.7 %). Significant risk factors for in-hospital mortality in multivariate analysis were polypnea (p = 0.001), age ≥ 75 years (p = 0.02), and severe sepsis or shock (p = 0.03) at the ED. Microbiological testing in 78.4 % of cases was positive in 15.4 % (n = 15): methicillin-resistant Staphylococcus aureus (26.7 %), Pseudomonas aeruginosa (20.0 %), S. pneumoniae (13.3 %), Escherichia coli (13.3 %), others (26.7 %); the rate of MDR bacteria was 53.3 %. This study reveals high rates of mortality and MDR bacteria among NHAP hospital admissions supporting the use of empirical broad-spectrum antibiotic therapy in these patients.