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精神分裂症患者併發院內肺炎的危險因子

Risk Factors Associated with Hospital-Acquired Pneumonia among Schizophrenia Patients

摘要


Objective: Poor clinical outcomes among patients with schizophrenia who simultaneously suffer from pneumonia have been reported. The aim of this study was to identify the potential risk factors associated with pneumonia among a cohort with schizophrenia using a case-control design study. Methods: This study enrolled a cohort with schizophrenia who had ever been hospitalized during 2008 at a psychiatric center in Taipei City. Of the cohort, seven subjects were identified as pneumonia cases. Ten controls were selected randomly for each case from the cohort and matched for age, sex, and the presence of hospitalization at the corresponding index date. Finally, six case-control pairs were included due to unavailability of controls for an elderly patient. The information was collected using reliable clinical judgment and a chart reviewing process. Results: The pneumonia group were found to have a higher proportion of individuals receiving treatment with clozapine (a second-generation antipsychotic drug) than the control group (100% vs. 33.3%, p=0.003). When the period of one week before the corresponding index date was investigated, the pneumonia group was likely to have coughing symptoms (83.3% vs. 3.3%, p<0.001) and to have been injected with a short-acting antipsychotic medication (66.7% vs. 1.7%, p<0.001). Conclusions: This study highlights several risk factors related to pneumonia among patients with schizophrenia, which include the use of clozapine, the presence of coughs, and an unstable psychiatric condition. These characteristics warrant further intensive clinical investigation.

並列摘要


Objective: Poor clinical outcomes among patients with schizophrenia who simultaneously suffer from pneumonia have been reported. The aim of this study was to identify the potential risk factors associated with pneumonia among a cohort with schizophrenia using a case-control design study. Methods: This study enrolled a cohort with schizophrenia who had ever been hospitalized during 2008 at a psychiatric center in Taipei City. Of the cohort, seven subjects were identified as pneumonia cases. Ten controls were selected randomly for each case from the cohort and matched for age, sex, and the presence of hospitalization at the corresponding index date. Finally, six case-control pairs were included due to unavailability of controls for an elderly patient. The information was collected using reliable clinical judgment and a chart reviewing process. Results: The pneumonia group were found to have a higher proportion of individuals receiving treatment with clozapine (a second-generation antipsychotic drug) than the control group (100% vs. 33.3%, p=0.003). When the period of one week before the corresponding index date was investigated, the pneumonia group was likely to have coughing symptoms (83.3% vs. 3.3%, p<0.001) and to have been injected with a short-acting antipsychotic medication (66.7% vs. 1.7%, p<0.001). Conclusions: This study highlights several risk factors related to pneumonia among patients with schizophrenia, which include the use of clozapine, the presence of coughs, and an unstable psychiatric condition. These characteristics warrant further intensive clinical investigation.

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