Pneumonia prevention in the elderly patients: the other sides

Chebib, Najla; Cuvelier, Clémence; Malézieux-Picard, Astrid; Parent, Thibault; Roux, Xavier; Fassier, Thomas; Müller, Frauke; Prendki, Virginie

doi:10.1007/s40520-019-01437-7

Cited by 45 publications

(28 citation statements)

References 115 publications

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“…3,5 In addition, pneumonia more frequently becomes the direct cause of death among the elderly, as they are more prone to the disease. 6,7 Pneumonia affects older persons more because there is a relative decline in immune function caused by aging, malnutrition, various chronic diseases, and other factors. 8 Community-acquired pneumonia (CAP) is the eighth leading cause of death in the United States and in adults aged 65 years and older.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of High‐Dose Vitamin D Supplementation as an Adjuvant Treatment on Pneumonia: Systematic Review and a Meta‐Analysis of Randomized Controlled Studies

et al. 2020

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The purpose of this meta-analysis was to summarize randomized controlled trial (RCT) evidence and evaluate the efficacy and safety of vitamin D (VD) supplementation as an adjunct to antibiotics for the treatment of pneumonia. Data sources published from the inception dates up to January 2020 were searched. RCTs of VD supplementation of any duration, age, and dosing regimen type were eligible for inclusion if data on pneumonia were collected. Thirteen studies (4786 randomized participants) fulfilled eligibility criteria. VD supplementation significantly increased levels of serum 25(OH)D (mean difference = 15.97; 95% CI, 7.49-24.44; P = .002) and reduced incidence of repeat episodes of pneumonia (risk ratio [RR] = 0.68; 95% CI, 0.50-0.93; P = .02). Subgroup analysis revealed VD supplementation had more reducing effects on repeat episodes of pneumonia among participants in trials in which the population were children (RR = 0.66; 95% CI, 0.48-0.90), duration <3 months (RR = 0.55; 95% CI, 0.33-0.91), or dose of VD <300,000 IU (RR = 0.51; 95% CI, 0.29-0.89). Although our results suggested that VD supplementation had a positive effect on recovery rate of pneumonia (RR = 1.28; 95% CI, 0.94-1.74; I 2 = 13%), there was no statistical difference (P = .12). High-dose VD intervention may have an effect on reducing the incidence rate of repeat episodes of pneumonia by enhancing immune efficacy, although more population studies are needed to support that VD supplementation has therapeutic effects on pneumonia itself.

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Section: Introductionmentioning

confidence: 99%

Efficacy of High‐Dose Vitamin D Supplementation as an Adjuvant Treatment on Pneumonia: Systematic Review and a Meta‐Analysis of Randomized Controlled Studies

et al. 2020

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“…However, this situation may change in the presence of certain diseases, such as nutritional or exercise-induced immune suppression, long-term use of antibiotics, dehydration, etc [28][29][30]. Little has been reported regarding whether lung infections affect oral hygiene [29]. This study found that SAP may be the leading risk factor for abnormal oral hygiene in patients with acute ischemic stroke, although the exact reason is not clear.…”

Section: Discussionmentioning

confidence: 76%

“…In general, abnormal oral hygiene was most closely related to personal hygiene habits. However, this situation may change in the presence of certain diseases, such as nutritional or exercise-induced immune suppression, long-term use of antibiotics, dehydration, etc [28][29][30]. Little has been reported regarding whether lung infections affect oral hygiene [29].…”

Section: Discussionmentioning

confidence: 99%

Mutually Risk Roles of Oral Cleanliness and Stroke-associated Pneumonia in Patients with Acute Ischemic Stroke: A Cross-Sectional Study

Yang

Chen

Yang

et al. 2020

Preprint

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Background: Stroke-associated pneumonia (SAP) is a major complication after stroke, oral microorganisms are important contributors to SAP. Here, we aimed to investigate whether the oral hygiene was associated with SAP and related risk factors of them in patients with acute ischemic stroke. Methods: We performed a cross-sectional study that recruited 331 patients with acute ischemic stroke from two medical centers. A series of assessments were performed to evaluate the neurological status and habits of oral hygiene. According to whether the oral hygiene was abnormal and SAP occurred, univariate analyses were performed in cohort 1 (normal / abnormal oral hygiene groups) and cohort 2 (SAP / non-SAP groups). Multiple logistic regression analyses were conducted to confirm risk factors of oral cleanliness and SAP in stroke patients. Results: A total of 12 and 8 independent variables were included in the model 1 and 2 analysis. After adjusting for confounders, multivariable logistic regression analysis showed that oral cleanliness was not only closely related to SAP (OR=2.219, P=0.026), dental caries (OR=1.292, P=0.005) and age (OR=1.030, P=0.006) in model 1, but also an independent risk factor for predicting SAP (OR=1.678, P=0.001) in model 2. Barthel index was a protective factor for oral cleanliness (OR=0.986, P=0.019) and SAP (OR=0.977, P=0.002) in ischemic stroke patients. Conclusions: Mutually primary risk roles of abnormal oral cleanliness and SAP exist in patients with acute ischemic stroke. Dental caries and aging are important risk factors for oral health disorders. Improving the activities of daily living would have protective effects on both oral hygiene and SAP prevention in stroke patients.

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“…In our study, only alcoholic drinking is associated with mortality risk. In the study of Chebib, et al it stated that alcohol consumption has a dose dependent effect and for older drinkers, they are more at risk for severe type of pneumonia and in-hospital mortality when compared to non-drinkers [17].…”

Section: Discussionmentioning

confidence: 99%

Prevalence, Demographic, Clinical Characteristics and Outcomes of Elderly Patients with Community Acquired Pneumonia Admitted in a Tertiary Medical Center: A Retrospective Cohort Study

B¹,

Joel²,

Adolf³

2021

J Geriatr Med Gerontol

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Objectives: To determine the prevalence, demographic data, clinical characteristics, microbiologic profile, clinical outcomes and risk factors of mortality among elderly with Community Acquired Pneumonia (CAP). Methods:This study was a retrospective cohort analysis utilizing data from January to December of 2018 among 159 elderly patients admitted with CAP in a tertiary hospital in the Philippines. Demographics, clinical characteristics, microbiologic profile was assessed using percentage and frequency. Chi-square test was used to compare factors to age group and risk factors of mortality were determined using binary logistic regression analysis. Results:The overall prevalence of elderly patients admitted with CAP was 5% and was noted to be higher in females (55.35%) than males (44.65%). Majority belonged to aged 65-74 years (36.5%). The most common pathogen identified is Escherichia coli (17.24%) and Streptococcus parasanguinis (17.17%) in blood and sputum culture, respectively. Risk factors significantly associated to mortality were history of alcoholic drinking, renal disease, oxygen saturation < 90% upon admission, decrease sensorium, hypotension, lung findings of retractions and decrease breath sounds, Escherichia coli in blood culture and mixed bacterial coinfection in sputum culture (p < 0.05). Conclusion:CAP is a common problem with clinical impact to elderly patients. The study was able to provide prevalence, demographic data and clinical characteristics associated with mortality among elderly patients admitted due to CAP. This study can also guide clinicians and hospital personnel in infection control and management strategies.

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Pneumonia prevention in the elderly patients: the other sides

Cited by 45 publications

References 115 publications

Efficacy of High‐Dose Vitamin D Supplementation as an Adjuvant Treatment on Pneumonia: Systematic Review and a Meta‐Analysis of Randomized Controlled Studies

Efficacy of High‐Dose Vitamin D Supplementation as an Adjuvant Treatment on Pneumonia: Systematic Review and a Meta‐Analysis of Randomized Controlled Studies

Mutually Risk Roles of Oral Cleanliness and Stroke-associated Pneumonia in Patients with Acute Ischemic Stroke: A Cross-Sectional Study

Prevalence, Demographic, Clinical Characteristics and Outcomes of Elderly Patients with Community Acquired Pneumonia Admitted in a Tertiary Medical Center: A Retrospective Cohort Study

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