TY -的T1 Guideline-concordant治疗和outcomes in healthcare-associated pneumonia JF - European Respiratory Journal JO - Eur Respir J SP - 878 LP - 887 DO - 10.1183/09031936.00141110 VL - 38 IS - 4 AU - Attridge, R.T. AU - Frei, C.R. AU - Restrepo, M.I. AU - Lawson, K.A. AU - Ryan, L. AU - Pugh, M.J.V. AU - Anzueto, A. AU - Mortensen, E.M. Y1 - 2011/10/01 UR - //www.qdcxjkg.com/content/38/4/878.abstract N2 - Healthcare-associated pneumonia (HCAP) guidelines were first proposed in 2005 but have not yet been validated. The objective of this study was to compare 30-day mortality in HCAP patients treated with either guideline-concordant (GC)-HCAP therapy or GC community-acquired pneumonia (CAP) therapy. We performed a population-based cohort study of >150 hospitals in the US Veterans Health Administration. Patients were included if they had one or more HCAP risk factors and received antibiotic therapy within 48 h of admission. Critically ill patients were excluded. Independent risk factors for 30-day mortality were determined in a generalised linear mixed-effect model, with admitting hospital as a random effect. Propensity scores for the probability of receiving GC-HCAP therapy were calculated and incorporated into a second logistic regression model. A total of 15,071 patients met study criteria and received GC-HCAP therapy (8.0%), GC-CAP therapy (75.7%) or non-GC therapy (16.3%). The strongest predictors of 30-day mortality were recent hospital admission (OR 2.49, 95% CI 2.12–2.94) and GC-HCAP therapy (OR 2.18, 95% CI 1.86–2.55). GC-HCAP therapy remained an independent risk factor for 30-day mortality (OR 2.12, 95% CI 1.82–2.48) in the propensity score analysis. In nonsevere HCAP patients, GC-HCAP therapy is not associated with improved survival compared with GC-CAP therapy. ER -