Home Care NetWork
Home Care Literature Reviews 2005
Community Acquired Pneumonia:
Marrie TJ, Huang JQ. Community-acquired pneumonia in patients receiving home care. J Am Geriatr Soc. 2005;53:834-9.
This Canadian prospective study characterized 2464 episodes of community acquired pneumonia to compare outcomes and in home care patients with the general population. The overall rate of pneumonia was 25 per 1000 patient years and over 90% of these were admitted to the hospital. Patients who were admitted were older and less likely to be current tobacco smokers, had higher in-hospital mortality (11%) and a longer length of stay, were receiving more medications, and had more comorbidity and fewer symptoms except for shortness of breath and altered mental state than those who were not receiving home care. Home care patients had four times as many myocardial infarctions and recurrent aspiration as the non-home care patients. Falls occurred five times more often, and urinary catheters were inserted twice as often. Except for oxygen saturation, time to achieve physiological stability was the same for the two groups of patients. Half (51.2%) of the home care patients passed the get-up-and-go test, compared with 75% (P<.001) of the non-home care patients. These results are not surprising given the fact that by definition home care patients have more morbidities than the general population. Nonetheless, this article gives a good view of the picture of community acquired ammonia and home care patients in Canada and, I suspect, in this country.
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