Practical Utility of a Clinical Pathway for Older Patients with Aspiration Pneumonia : A Single-Center Retrospective Observational Study
Introduction: Clinical pathways (CPWs) are patient management tools based on a standardized treatment plan aimed at improving quality of care. This study aimed to investigate whether CPW-guided treatment has a favorable impact on the outcomes of hospitalized older patients with aspiration pneumonia. Method: This retrospective study included patients with aspiration pneumonia, aged ≥ 65 years, and hospitalized at a community hospital in Japan. CPW implementation was arbitrarily determined by the attending physician upon admission. Outcomes were compared according to with or without the CPW (CPW-group and non-CPW groups). Propensity score (PS)-based analyses were used to control for confounding factors. Logistic regression analyses were conducted to evaluate the impact of CPW on the clinical course and outcomes. Results: Of 596 included patients, 167 (28%) received the CPW-guided treatment. The mortality rate was 16.4%. In multivariable model, CPW implementation did not increase the risk for total and 30-day mortality, and resulted in shorter antibiotic therapy duration (≤9 days) (PS matching (PSM): odds ratio (OR) 0.50, p = 0.001; inverse provability of treatment weighting (IPTW): OR 0.48, p < 0.001) and length of hospital stay (≤21 days) (PSM: OR 0.67, p = 0.05; IPTW: OR 0.66, p = 0.03). Conclusions: This study support CPW utility in this population.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:13 |
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| Enthalten in: |
Journal of clinical medicine - 13(2023), 1 vom: 30. Dez. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Araki, Taisuke [VerfasserIn] |
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| Links: |
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| Themen: |
Aspiration pneumonia |
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| Anmerkungen: |
Date Revised 12.01.2024 published: Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3390/jcm13010230 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM366928198 |
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| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Introduction: Clinical pathways (CPWs) are patient management tools based on a standardized treatment plan aimed at improving quality of care. This study aimed to investigate whether CPW-guided treatment has a favorable impact on the outcomes of hospitalized older patients with aspiration pneumonia. Method: This retrospective study included patients with aspiration pneumonia, aged ≥ 65 years, and hospitalized at a community hospital in Japan. CPW implementation was arbitrarily determined by the attending physician upon admission. Outcomes were compared according to with or without the CPW (CPW-group and non-CPW groups). Propensity score (PS)-based analyses were used to control for confounding factors. Logistic regression analyses were conducted to evaluate the impact of CPW on the clinical course and outcomes. Results: Of 596 included patients, 167 (28%) received the CPW-guided treatment. The mortality rate was 16.4%. In multivariable model, CPW implementation did not increase the risk for total and 30-day mortality, and resulted in shorter antibiotic therapy duration (≤9 days) (PS matching (PSM): odds ratio (OR) 0.50, p = 0.001; inverse provability of treatment weighting (IPTW): OR 0.48, p < 0.001) and length of hospital stay (≤21 days) (PSM: OR 0.67, p = 0.05; IPTW: OR 0.66, p = 0.03). Conclusions: This study support CPW utility in this population | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a aspiration pneumonia | |
| 650 | 4 | |a clinical pathway | |
| 650 | 4 | |a inverse probability of treatment weighting | |
| 650 | 4 | |a older patients | |
| 650 | 4 | |a prognosis | |
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| 650 | 4 | |a propensity score matching | |
| 700 | 1 | |a Yamazaki, Yoshitaka |e verfasserin |4 aut | |
| 700 | 1 | |a Kimoto, Masanobu |e verfasserin |4 aut | |
| 700 | 1 | |a Goto, Norihiko |e verfasserin |4 aut | |
| 700 | 1 | |a Ikuyama, Yuichi |e verfasserin |4 aut | |
| 700 | 1 | |a Takahashi, Yuko |e verfasserin |4 aut | |
| 700 | 1 | |a Kosaka, Makoto |e verfasserin |4 aut | |
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