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Hospitalized patients may have many risk factors for pneumonia, including mechanical ventilation, prolonged malnutrition, underlying heart and lung diseases, decreased amounts of stomach acid, and immune disturbances. Additionally, the microorganisms a person is exposed to in a hospital are often different from those at home.
HAP, or nosocomial pneumonia, is a lower respiratory infection that was not incubating at the time of hospital admission and that presents clinically two or more days after hospitalization. [49] Ventilator-associated pneumonia (VAP) is defined as HAP in patients receiving mechanical ventilation.
In 2002, an expert panel made recommendations about the evaluation and treatment of probable nursing home-acquired pneumonia. [22] They defined probably pneumonia, emphasized expedite antibiotic treatment (which is known to improve survival) and drafted criteria for the hospitalization of willing patients.
Immune problems - Immune-deficient patients, such as those with HIV/AIDS, are more likely to develop pneumonia. Other immune problems that increase the risk of developing pneumonia range from severe childhood immune deficiencies, such as Wiskott–Aldrich syndrome, to the less severe common variable immunodeficiency. [10]
In the frail elderly good oral health care may lower the risk of aspiration pneumonia, [103] even though there is no good evidence that one approach to mouth care is better than others in preventing nursing home acquired pneumonia. [104] Zinc supplementation in children 2 months to five years old appears to reduce rates of pneumonia. [105]
Pneumonia and sepsis are the most common triggers, and pneumonia is present in up to 60% of patients and may be either causes or complications of ARDS. Alcohol excess appears to increase the risk of ARDS. [47] Diabetes was originally thought to decrease the risk of ARDS, but this has shown to be due to an increase in the risk of pulmonary edema.
Pneumonia is a common respiratory infection, [2] affecting approximately 450 million people a year and occurring in all parts of the world. [3] It is a major cause of death among all age groups, resulting in 1.4 million deaths in 2010 (7% of the world's yearly total) and 3.0 million deaths in 2016 (the 4th leading cause of death in the world).
DRGs were intended to describe all types of patients in an acute hospital setting. DRGs encompassed elderly patients as well as new born, pediatric and adult populations. [14] The prospective payment system implemented as DRGs had been designed to limit the share of hospital revenues derived from the Medicare program budget. [11]