Multicenter Survey on Hospital-acquired Pneumonia and the Clinical Efficacy of First-line Antibiotics in Japan

Abstract

Objective The aim of this study was to investigate the pathophysiology of hospital-acquired pneumonia (HAP)

Revision of the severity rating and classification of hospital‐acquired pneumonia in the Japanese Respiratory Society guidelines

“…Risk factors associated with prognosis in the HAP survey, 10 were selected and investigated, to identify those most relevant for severity classification. The five factors selected were very similar to the assessment factors used in A-DROP, except that "malignant tumour or immunocompromised status" was adopted instead of "blood pressure (shock)".…”

“…10 Of these factors, 10 The survey showed that prognosis was poor for patients with cellular immunocompromised status, while some patients had multiple immunosuppressive states such as cellular and humoral immunosuppressive states. In addition, since there were no pronounced differences among the presumptive causative organisms (data not shown), these two conditions were merged as "immunocompromised status", and the assessment parameter was combined with the associated disease state, malignant tumour, to yield "malignant tumour and/or immunocompromised status".…”

“…10 Thus, it was combined with the associated disease state, oliguria, to create the assessment parameter "oliguria or dehydration", similar to the A-DROP criterion.…”

“…12 The performance of CURB-65 in predicting mortality due to HAP in Japan has been examined. 10 As information on blood-urea nitrogen was not collected in the HAP survey, The mortality rate for patients classified by CURB-65 score was compared with that for patients classified according to the criteria used in this study (Table 6). Thirty-one patients in the high-risk group had CURB-65 scores of 0-1, and the mortality rate was 45.2%.…”

“…In addition, among patients categorized in Group III, there were differences in mortality rate with the severity of pneumonia. 10 …”