Disturbingly high rate of home care patients are being admitted to hospital suffering from pneumonia

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A disturbingly high rate of home care patients are being admitted to hospital suffering from pneumonia, and also suffer more complications, according to a study from the University of Alberta.

A two-year study showed home-care patients suffering from Community-Acquired Pneumonia (CAP is acquired outside of hospitals) account for 25 of every 1,000 people who visited emergency rooms suffering pneumonia. In addition, 90 per cent of those people had to be admitted to hospital for treatment. They also had a mortality rate 11 per cent higher than other patients, as well as a longer length of stay. They suffered four times as many heart attacks, fell five times more often, and had urinary catheters inserted twice as often.

The study, which focused on six hospitals in Canada and 2,464 subjects aged 17 and older, is the first to document the high rate of CAP in home care patients and to compare the features of this illness with those who are not receiving home care. Results are published in the May, 2005 Journal of the American Geriatrics Society.

"Patients who are receiving home care are at higher risk for pneumonia because of the reasons they require home care. They are usually unable to function independently, so they are more frail than people of the same age and gender who don't require home care," said Dr. Thomas Marrie, lead author on the study, and dean of the University of Alberta Faculty of Medicine and Dentistry.

"We now need to do more defined studies to pinpoint the reasons for this increased rate of pneumonia. It may be because frail patients can't fight infection as well as those who are totally healthy," he added.

"It is apparent that home care patients need to be carefully studied to define the factors that lead to such a high rate of pneumonia," Dr. Marrie added. "It is also apparent that physicians need to be aware of this fact. That will allow physicians to emphasize prevention of pneumonia to their patients who are receiving home care by good nutrition, and vaccination against influenza and pneumonia."

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