Pneumonia in residents of long-term care facilities : Epidemiology, etiology, management, and prevention.
Pneumonia is a leading cause of morbidity and mortality among patients in long-term care facilities ; the median reported incidence is I per 1,000 patient-days.
Risk factors include functional dependency, chronic pulmonary disease, and conditions causing aspiration.
The frequency of etiologic agents varies widely among reports ; for example ; Streptococcus pneumoniae ranges from 0% to 39% of cases, and gram negative bacilli ranges from 0% to 51% of reported cases.
Viral respiratory infections, particularly influenza and respiratory syncytial virus, typically occur in outbreaks.
Mortality varies from 5% to 40% ; functional status is the major determinant of survival.
Many patients receive inadequate initial evaluations, and as many as 40% receive no physician visit during the episode.
Although transfer to an acute care facility occurs in 9% to 51% of cases, most transferred patients could be managed in the nursing home with minimal additional support.
Appropriate evaluation includes examination by a practitioner, recording of vital signs, chest radiograph, and examination ofan adequate sputum sample, if available.
Patients without contraindications to oral therapy or severe abnormalities of vital signs (pulse>120 beats per minute, respirations>30 per minute, systolic blood pressure<90) may initially receive oral therapy. (...)
Mots-clés Pascal : Pneumonie, Vieillard, Homme, Long séjour, Epidémiologie, Etiologie, Stratégie, Prévention, Arbre décision, Article synthèse, Evaluation, Etablissement troisième âge, Pennsylvanie, Etats Unis, Amérique du Nord, Amérique, Appareil respiratoire pathologie, Poumon pathologie
Mots-clés Pascal anglais : Pneumonia, Elderly, Human, Long stay, Epidemiology, Etiology, Strategy, Prevention, Decision tree, Review, Evaluation, Homes for the aged, Pennsylvania, United States, North America, America, Respiratory disease, Lung disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0527292
Code Inist : 002B11D. Création : 23/03/1999.