A prospective study of ADL and salivary CRP in relation to pneumonia in elderly people

2023 Fiscal Year Final Research Report

• Project/Area Number: 19K16946
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 52010:General internal medicine-related
• Research Institution: Niigata University
• Principal Investigator: Takeshi Koizumi 新潟大学, 医歯学総合研究科, 客員研究員 (10793888)
• Project Period (FY): 2019-04-01 – 2024-03-31
• Keywords: 医療介護関連肺炎 / 肺炎初回死亡率 / PT / OT

Outline of Final Research Achievements

The data for a total of 836 patients (65.8％ of patients admitted with pneumonia, with an age of 85.2±8.7 years,)with a median age of 64 years) were analyzed. Mortality rate of pneumonia correlated with pneumonia severity at admission, but no association was observed with antibiotics. (Cochran-Armitage trend test p<0.01).
In addition, the mortality rate from first-time pneumonia differed significantly depending on whether or not physical therapy (PT) or occupational therapy (OT) was administered. In a comparison between the PT/OT intervention group and the non-intervention group after propensity score matching based on age, sex, pre-hospitalization ADL, comorbidities, and severity classification, the mortality rate from first-time pneumonia was 1.6% in the intervention group and 18.4% in the non-intervention group (p<0.01, N=185 cases each).

Free Research Field

呼吸器感染症

Academic Significance and Societal Importance of the Research Achievements

今回の研究では、新型コロナウイルス感染症の流行防止の観点から唾液の評価が困難となり、肺炎入院症例の解析のみを実施した。
高齢化率が上昇している本邦において、医療介護関連肺炎の治療戦略を確立することは非常に重要である。抗菌薬選択による予後の差はなく、リハビリの介入により、予後改善が得られるという結果は、今後の高齢者肺炎治療に関しての有効な治療の確立に大きな意義があったと考える。抗菌薬治療ではなく、リハビリ介入が予後に直接影響したことをデータとして示した点は、これまでの報告も多くなく、非常に貴重なデータといえる。