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Community versus academic hospital community-acquired pneumonia patients: a nested cohort study

2024-11-25Journal article Open access
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dc.contributor.authorTsang, Jennifer L. Y.
dc.contributor.authorRego, Kian
dc.contributor.authorBinnie, Alexandra
dc.contributor.authorBinnie, Alexandra
dc.contributor.authorLee, Terry
dc.contributor.authorMccarthy, Anne
dc.contributor.authorCowan, Juthaporn
dc.contributor.authorArchambault, Patrick
dc.contributor.authorLellouche, Francois
dc.contributor.authorTurgeon, Alexis F.
dc.contributor.authorYoon, Jennifer
dc.contributor.authorLamontagne, Francois
dc.contributor.authorMcgeer, Allison
dc.contributor.authorDouglas, Josh
dc.contributor.authorDaley, Peter
dc.contributor.authorFowler, Robert
dc.contributor.authorMaslove, David M.
dc.contributor.authorWinston, Brent W.
dc.contributor.authorLee, Todd C.
dc.contributor.authorTran, Karen C.
dc.contributor.authorCheng, Matthew P.
dc.contributor.authorVinh, Donald C.
dc.contributor.authorBoyd, John H.
dc.contributor.authorWalley, Keith R.
dc.contributor.authorSinger, Joel
dc.contributor.authorMarshall, John C.
dc.contributor.authorHaljan, Gregory
dc.contributor.authorJain, Fagun
dc.contributor.authorRussell, James A.
dc.date.accessioned2024-12-10T09:47:15Z
dc.date.available2024-12-10T09:47:15Z
dc.date.issued2024-11-25
dc.description.abstractBackground: Most Canadians receive their care in community hospitals, yet most clinical research is conducted in academic hospitals. This study aims to compare patients with community acquired pneumonia (CAP) treated in academic and community hospitals with respect to their demographics, clinical characteristics, treatments and outcomes. Methods This nested observational cohort substudy of the Community Acquired Pneumonia: Toward InnoVAtive Treatment (CAPTIVATE) trial included 1,329 hospitalized adults with CAP recruited between March 1st, 2018 and September 31st, 2023 from 15 Canadian hospitals. Unadjusted and adjusted analyses for age, sex and co-morbidities using logistic, Cox and censored quantile regressions were conducted. Results Patients in community hospitals were older (mean [SD] 75.0 [15.7] years vs. 68.3 [16.2] years; p < 0.001), were more likely to be female (49.7% vs. 41.0%, p = 0.002), and had more comorbidities (75.9% vs. 64.8%, p < 0.001). More patients in community hospitals received corticosteroids (49.2% vs. 37.4%, p < 0.001). Community hospital patients had a higher likelihood of developing acute respiratory distress syndrome (OR 3.13, 95% CI: 1.87, 5.24, p = < 0.001), and acute cardiac injury (OR 2.53, 95% CI: 1.33, 4.83, p = 0.005). In unadjusted and adjusted analyses, 28-day mortality difference did not meet statistical significance (OR 1.43, 95% CI: 0.98, 20.7, p = 0.062 and OR 1.23, 95% CI: 0.81, 1.87, p = 0.332, respective). Conclusion Patients with CAP in Canadian community and academic hospitals differed with respect to their age, clinical characteristics, treatments and outcomes, emphasizing the importance of including more community hospitals in clinical research studies to ensure the generalizability of results.eng
dc.description.sponsorshipGrant number: 439993
dc.identifier.doi10.1186/s41479-024-00143-x
dc.identifier.issn2200-6133
dc.identifier.urihttp://hdl.handle.net/10400.1/26436
dc.language.isoeng
dc.peerreviewedyes
dc.publisherSpringer
dc.relation.hasversionhttps://pneumonia.biomedcentral.com/articles/10.1186/s41479-024-00143-x
dc.relation.ispartofPneumonia
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectCommunity hospital
dc.subjectCommunity-acquired pneumonia
dc.subjectCorticosteroids
dc.subjectMortality
dc.titleCommunity versus academic hospital community-acquired pneumonia patients: a nested cohort studyeng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue1
oaire.citation.startPage31
oaire.citation.titlePneumonia
oaire.citation.volume16
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameBinnie
person.givenNameAlexandra
person.identifier.ciencia-idC212-F6D7-8240
person.identifier.orcid0000-0003-2969-8177
person.identifier.scopus-author-id7004219471
relation.isAuthorOfPublication8fa20244-f180-45e9-a12b-3c612d67bc70
relation.isAuthorOfPublication.latestForDiscovery8fa20244-f180-45e9-a12b-3c612d67bc70

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