Abstract:
BACKGROUND:Although marital status has been shown to affect the outcomes of many conditions, there are limited data on the relationships between marital status and the presentation and outcomes of pneumonia. METHODS:We used Veterans Affairs administrative databases to identify a retrospective cohort of male veterans age ≥ 65 years hospitalized for pneumonia between 2002 and 2007. We assessed unadjusted and adjusted associations between marital status and mortality, hospital length of stay, and readmission to the hospital using generalized linear mixed-effect models with admitting hospital as a random effect and adjusted for baseline patient characteristics. RESULTS:There were 48,635 patients (26,558 married and 22,077 unmarried) in the study. Married men had a slightly higher Charlson comorbidity score (3.0 vs 2.8, P < .0001) but were less likely to require ICU admission, ventilator support, and vasopressor treatment during the first 48 h of hospitalization. Married patients had significantly lower crude and adjusted in-hospital mortality (9.4% vs 10.6%; adjusted OR, 0.87; 95% CI, 0.81-0.93) and mortality during the 90 days after hospital discharge (14.7% vs 16.0%; adjusted OR, 0.92; 95% CI, 0.88-0.98). Their adjusted incidence rate ratio length of stay was also lower (0.92; 95% CI, 0.91-0.92). CONCLUSIONS:Unmarried elderly men admitted to the hospital with pneumonia have a higher risk of in-hospital and postdischarge mortality, despite having a lower degree of comorbidity. Although marital status may be a surrogate marker for other predictors, it is an easily identifiable one. These results should be considered by those responsible for care-transition decisions for patients hospitalized with pneumonia.
journal_name
Chestjournal_title
Chestauthors
Metersky ML,Fine MJ,Mortensen EMdoi
10.1378/chest.11-3183subject
Has Abstractpub_date
2012-10-01 00:00:00pages
982-987issue
4eissn
0012-3692issn
1931-3543pii
S0012-3692(12)60568-6journal_volume
142pub_type
杂志文章,多中心研究相关文献
CHEST文献大全abstract:BACKGROUND:Signs of both motor and sensory nervous lesions have previously been shown in the upper airway of patients with OSA and habitual snorers. Snoring per se may damage all upper airway neurons over time, thereby causing progression to manifest sleep apnea. To test this hypothesis, nonsnoring subjects, untreated ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2020.01.032
更新日期:2020-05-01 00:00:00
abstract::The effect of intravenous (IV) amiodarone (300 mg) on heart rate was investigated in 22 patients with acute myocardial infarction (18) or ischemia (4) and sinus tachycardia. There were 11 men and 11 women (age range, 48 to 83 years; mean, 63.5). Amiodarone IV slowed the mean heart rate from 109 +/- 14 beats/min to 94 ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.94.3.584
更新日期:1988-09-01 00:00:00
abstract::Thoracic splenosis (post-traumatic autotransplantation of splenic tissue) is rare and generally asymptomatic. We report a patient with thoracic splenosis presenting with repeated hemoptysis. The blood supply of the hypervascular splenic transplants originated from a bronchial and an intercostal artery. Hemoptysis impr...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.102.2.626
更新日期:1992-08-01 00:00:00
abstract::The variation in respiratory water loss (RWL) over time, expressed as the mass of water vapor lost per liter (body temperature and pressure, saturated) of ventilation (MH2O), was investigated in two groups: (1) children with exercise-induced asthma; and (2) healthy children. Children were matched for age and sex and w...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.94.1.81
更新日期:1988-07-01 00:00:00
abstract::The work of chest inflation, WI, is a primary determinant of the need for ventilatory support and an integrative index of elastic and resistive impedance. Although the mechanical work performed by a ventilator in moving gas into the passive chest (WI = integral of PV dt) can be determined by measuring the area enclose...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.89.1.56
更新日期:1986-01-01 00:00:00
abstract::A 72-year-old man presented with malaise, weight loss, and cough. Chest radiograph revealed bilateral pleural effusions. On thoracentesis, the left effusion was a clear yellow exudate with more than 90% lymphocytes, and the right effusion was a grossly bloody exudate with more than 90% neutrophils. Cultures of both ef...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.110.3.849
更新日期:1996-09-01 00:00:00
abstract::This is the report of a 38-year-old man with unilateral dermatomal hyperhidrosis documented by a starch-iodine technique; a subsequent diagnosis was made of a generalized pulmonary adenocarcinoma. The association of unilateral hyperhidrosis and a malignant tumor is reviewed. ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.114.4.1215
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:Individual studies have reported widely variable rates for VTE and bleeding among hospitalized patients with coronavirus disease 2019 (COVID-19). RESEARCH QUESTION:What is the incidence of VTE and bleeding among hospitalized patients with COVID-19? METHODS:In this systematic review and meta-analysis, 15 st...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2020.11.005
更新日期:2020-11-17 00:00:00
abstract::Studies using epicardial mapping on patients with Wolff-Parkinson-White syndrome have demonstrated that the delta vector of the electrocardiogram is a detector of the location of at least one bypass tract. In order to relate the electrical activities (preexcitation) with the mechanical activity (septal and ventricular...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.71.4.463
更新日期:1977-04-01 00:00:00
abstract::Adverse cardiovascular effects are commonly seen in severe theophylline poisoning. Primary ST-T wave changes have not been described previously. We report T wave inversion associated with severe theophylline toxicity in a 33-year-old woman with no evidence of organic heart disease. The T wave inversion resolved after ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.96.2.429
更新日期:1989-08-01 00:00:00
abstract::A 55-year-old woman underwent bronchoscopic evaluation for hemoptysis. A small polypoid endotracheal nodule was discovered approximately 2.0 cm distal to the left true vocal cord. The lesion was sampled with a cytologic brush. Epithelioid histiocytes and numerous giant cells with asteroid bodies were seen, and there w...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.104.1.311
更新日期:1993-07-01 00:00:00
abstract::The etiology of the SAS is unknown. To test whether endogenous opioids could be pathologically active in SAS, markers of opioid systems were measured in the CSF of 15 patients with SAS and in control subjects. Measured by receptor assay, the concentration of so-called fraction 1 opioid was higher in patients with SAS ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.96.2.250
更新日期:1989-08-01 00:00:00
abstract::The effect of clenbuterol, a beta adrenergic drug, and ambroxol, a secretolytic agent, on regional mucociliary clearance and pulmonary radioaerosol distribution was investigated in two groups of 15 patients with COLD in a double-blind cross-over trial with placebo. Clearance rates of inhaled 99mTc-labelled human serum...
journal_title:Chest
pub_type: 临床试验,杂志文章
doi:10.1378/chest.80.6.881
更新日期:1981-12-01 00:00:00
abstract:STUDY OBJECTIVE:This study aimed to evaluate the effects of nasal continuous positive airway pressure (nCPAP) therapy on sleep and daytime symptoms of bed partners and patients with obstructive sleep apnea (OSA). DESIGN:A cross-sectional questionnaire survey. SETTING:The sleep laboratory of a university teaching hosp...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.111.5.1261
更新日期:1997-05-01 00:00:00
abstract::We compared the bronchodilator effects and systemic tolerability of 12, 24 and 48 micrograms formoterol DP capsules with 12 micrograms formoterol MDI and placebo in 30 patients with reversible obstructive airway disease. Pulmonary function tests were done and pulse rate and blood pressure were recorded. We observed si...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.101.5.1376
更新日期:1992-05-01 00:00:00
abstract:STUDY OBJECTIVE:The tuberculin skin test is the best diagnostic method to detect tuberculous infection. How accurate is interpretation of the test? DESIGN:Observational study. SETTING:Both general hospital and university hospital. PARTICIPANTS:One hundred seven health-care professionals, including 52 practicing pedi...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.113.5.1175
更新日期:1998-05-01 00:00:00
abstract::In two patients with acute dissection of the ascending aorta, the diagnosis was made with two-dimensional echocardiography and confirmed by aortography. The echocardiograms localized the intimal flap and false channel in both cases. Although clinical evaluation and indicated radiologic studies remain the primary modal...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.80.5.587
更新日期:1981-11-01 00:00:00
abstract:BACKGROUND:Venous thromboembolism (VTE) remains a major cause of morbidity following stroke. The optimal form of pharmacologic prophylaxis following stroke is unknown. METHODS:We identified randomized trials comparing unfractionated heparin (UFH) to low-molecular-weight heparin (LMWH) for VTE prevention in ischemic st...
journal_title:Chest
pub_type: 杂志文章,meta分析
doi:10.1378/chest.07-1826
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:COPD is associated with significant morbidity primarily driven by acute exacerbations. Relative pulmonary artery (PA) enlargement, defined as a PA to ascending aorta (A) diameter ratio greater than one (PA:A>1) identifies patients at increased risk for exacerbations. However, little is known about the correl...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.13-1422
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence of electrolyte disturbances in patients with chronic, stable asthma, and to assess whether the therapeutic agents used to treat chronic asthma have an effect on abnormal electrolyte levels. DESIGN:Prospective, hospital-based, cross-sectional study. SETTING:University teaching hos...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.120.2.431
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:Upper airway edema might contribute to pharyngeal collapsibility and account for the high prevalence of obstructive sleep apnea (OSA) in patients with heart disease. The aim of this study was to evaluate if intensive unloading with diuretics improves sleep-disordered breathing and increases pharyngeal calibe...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.07-0311
更新日期:2007-08-01 00:00:00
abstract::In previous research, we have demonstrated the value of using necropsy "surprise" lung cancer cases, in those in whom lung cancer was not suspected during life, to estimate the size and composition of the "reservoir" of undetected lung cancer in the general population. The current research was done to determine the ch...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.96.2.291
更新日期:1989-08-01 00:00:00
abstract::Oxygen uptake (VO2) reflects the rate of aerobic regeneration of high-energy phosphate compounds (primarily adenosine triphosphate [ATP]). Since lactate increase is thought to result from an inadequate rate of aerobic ATP regeneration, it might be expected that lactate increase would be associated with a delayed attai...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.3.735
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:A paucity of studies have assessed the epidemiology of community-acquired pneumonia (CAP) that require ICU admission. We conducted a study on this group of patients with the primary objective of defining the incidence, epidemiology, and mortality rate of CAP in the ICUs in Louisville, Kentucky. The secondary...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2020.03.051
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:The duration of postinspiratory pause prior to forced expiration may significantly influence the peak expiratory flow (PEF) measured during maximal forceful expirations. In comparison with maneuvers without a postinspiratory pause, maneuvers with 4 to 6-s pause at total lung capacity (TLC) result in decrease...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.128.1.442
更新日期:2005-07-01 00:00:00
abstract::Mucoepidermoid carcinoma of the trachea is rare. Its occurence in a 14-year-old boy is reported here. This case illustrates the typical course of tracheal tumors with clinical manifestations of cough, wheezing, and hemoptysis, the intially reported normal chest roentgenogram, and the common failure to diagnose trachea...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.70.6.782
更新日期:1976-12-01 00:00:00
abstract:BACKGROUND:Electromagnetic navigation bronchoscopy (ENB) with biopsy under fluoroscopic guidance has enhanced the yield of flexible bronchoscopy in the diagnosis of peripheral lung lesions. However, the accuracy of ENB navigation suggests that the addition of fluoroscopy is redundant. OBJECTIVES:Data were prospectivel...
journal_title:Chest
pub_type: 临床试验,杂志文章
doi:10.1378/chest.06-3016
更新日期:2007-06-01 00:00:00
abstract::To determine the efficacy of doxycycline as a pleural sclerosing agent, we examined the outcomes in 31 patients (aged 31 to 87 years) receiving doxycycline (500 to 1,000 mg) through a chest tube for malignant pleural effusions or persistent bronchopleural fistulae. Of the 27 patients with malignant pleural effusions, ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.105.6.1743
更新日期:1994-06-01 00:00:00
abstract::A case of acute tuberculous pneumonia diagnosed by transbronchial biopsy is presented. We postulate that the unusually rapid progression was due to an exudative hypersensitivity reaction to aspirated tuberculoprotein. ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.71.6.774
更新日期:1977-06-01 00:00:00
abstract::Three patients had angiographic appearance of chronic primary coronary artery dissection with features that differed from other patients with this entity studied at autopsy; they were men, greater than or equal to 40 years of age, had angina pectoris and severe coronary artery disease. The right coronary artery, which...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.87.2.227
更新日期:1985-02-01 00:00:00