@article {Rikimarup2459, author = {Toru Rikimaru and Noriko Hukushima and Reiko Toda}, title = {Pneumonia in patients who received health care at home {\textendash} Should they be categorized as CAP or HCAP?}, volume = {38}, number = {Suppl 55}, elocation-id = {p2459}, year = {2011}, publisher = {European Respiratory Society}, abstract = {Introduction: Healthcare-associated pneumonia (HCAP) is a condition in patients (pts) who are not hospitalized but features are similar to hospital-acquired pneumonia. There are many people who receive HC at home instead of at a nursing home (NH). It is not clear whether thay should be treated as community-acquired pneumonia (CAP) or HCAP.Aims and objectives: This study sought to declare the features in pts who received HC at home, and to classify them as CAP or HCAP by comparing them with CAP and NH-acquired pneumonia (NHAP) which occupy an important position in HCAP.Methods: We evaluated and separated 1000 pts into three groups, Group A 517 pts; complete CAP (A), Group B 333 pts; NHAP (B), and Group C 160 pts; who received HC at home (C).Results: The features of C were similar to B in age, and between A and B in sex, total protein and independency. There were no differences between the three groups in body temperature, WBC and CRP. In bacteriological features, S. pneumoniae, H. influenzae and K. pneumoniae were 9.5\%, 5.8\% and 3.9\% in A, 7.2\%, 2.2\% and 10.9\% in B and 3.6\%, 5.5\% and 9.1\% in C, respectively. Other features of B and C were similar and had many drug-resistant pathogens e.g. MRSA (A: 5.3\%, B: 21.0\%, C: 16.4\%) and P. aeruginosa (A: 2.5\%, B: 13.4\%, C: 10.9\%). Mortality rates of A, B and C were 6.0\%, 18.6\% and 10.0\%, respectively. In restricted analysis within total care pts of C, the clinical features were more similar to B, with a mortality of 18.4\%.Conclusions: The clinical features of C were similar to NHAP in many categories. We concluded that pneumonia in pts who have received HC at home should be classified as HCAP, especially in poor independency pts.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/38/Suppl_55/p2459}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }