Evaluation of multi-component interventions for prevention of nosocomial pneumonia in older adults: a randomized, controlled trial
| Autor: | Arron Seng Hock Ang, Anthony Yii, Aza Taha, Pei Ting Tan, Yan Qing Lee, Wendy Ang, Aniruddha Sahu, Gek Kheng Png, Louis Y Tee, Roslinda Binte Slamat, Yi Ling Zheng, Humaira Shafi, Barbara Helen Rosario, Lin Fang Zhou |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Randomization Psychological intervention law.invention 03 medical and health sciences 0302 clinical medicine Nosocomial infection Randomized controlled trial law Internal medicine medicine Humans 030212 general & internal medicine Aged Aged 80 and over Cross Infection 030214 geriatrics business.industry SARS-CoV-2 Incidence (epidemiology) Healthcare-Associated Pneumonia Respiratory infection COVID-19 Pneumonia medicine.disease Vaccination Treatment Outcome Older adults Female Multi-component interventions medicine.symptom business Oropharyngeal dysphagia Research Paper |
| Zdroj: | European Geriatric Medicine |
| ISSN: | 1878-7657 1878-7649 |
| Popis: | Key Summary points Aim RCT to evaluate the efficacy of multi-component interventions for prevention of hospital-acquired pneumonia in hospitalized older patients. Findings The multi-component interventions did not reduce hospital-acquired pneumonia but increased the mean time to next hospitalisation due to respiratory infection (11.5 months vs. 9.5 months; P = 0.049), and reduced the risk of hospitalisation in 1 year (18.6% vs. 34.4%; P = 0.049). This was likely due to the increased recognition of oropharyngeal dysphagia (35.6% vs. 20.3%; P < 0.001) and improved influenza (54.5% vs 17.2%; P < 0.001) and pneumococcal vaccination rates (52.5% vs. 20.3%; P < 0.001). Message A multi-component intervention for nosocomial pneumonia may not significantly reduce the incidence of hospital-acquired pneumonia but significantly increases the frequency of diagnosis of oropharyngeal dysphagia, improves vaccination rates and can reduce future hospitalisations for respiratory infections in older adults. Aims To evaluate the efficacy of multi-component interventions for prevention of hospital-acquired pneumonia in older patients hospitalized in geriatric wards. Methods A randomized, parallel-group, controlled trial was undertaken in patients aged 65 and above who were admitted to a tertiary hospital geriatric unit from January 1, 2016 to June 30, 2018 for an acute non-respiratory illness. Participants were randomized by to receive either a multi-component intervention (consisting of reverse Trendelenburg position, dysphagia screening, oral care and vaccinations), or usual care. The outcome measures were the proportion of patients who developed hospital-acquired pneumonia during hospitalisation, and mean time from randomization to the next hospitalisation due to respiratory infections in 1 year. Results A total of 123 participants (median age, 85; 43.1% male) were randomized, (n = 59) to intervention group and (n = 64) to control group. The multi-component interventions did not significantly reduce the incidence of hospital-acquired pneumonia but did increase the mean time to next hospitalisation due to respiratory infection (11.5 months vs. 9.5 months; P = 0.049), and reduced the risk of hospitalisation in 1 year (18.6% vs. 34.4%; P = 0.049). Implementation of multi-component interventions increased diagnoses of oropharyngeal dysphagia (35.6% vs. 20.3%; P |
| Databáze: | OpenAIRE |
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