OBJECTIVE: To describe provider practice patterns in the diagnosis and treatment of Nursing Home-Acquired @entity55 (NHAP) and to document associations with cure, mortality, and transfer. DESIGN: A retrospective cohort. SETTING: Six nursing homes in Seattle, Washington. @entity1 : A total of 94 @entity1 , 65 years of age or older (mean 83 +/- SD 9), in whom the diagnosis of @entity55 was documented in the nursing home medical record between July 1, 1994, and June 6, 1995. MEASUREMENTS: Multivariate logistic regression was used to assess the relationship between descriptive, diagnostic, or therapeutic measures and three outcomes, cure, 30-day mortality, and hospital transfer. RESULTS: Ninety-four episodes of @entity55 were identified. Allowing for more than one outcome per @entity1 , there were 71 (75.5%) cures, 16 (17%) deaths, and nine (9.6%) transfers. Eighty-five percent of @entity1 identified as having NHAP by their providers had chest X-rays (CXRs), and 69% had physical examinations. Sputum examination was ordered in 5%, blood cultures in 6%, and white blood cell counts in 33% of @entity1 . In multivariate analysis, @entity1 with functional decline were more likely to die (Odds Ratio (OR) 36.5 (95% CI 6.1, 220)). @entity73 was a risk factor for mortality (OR 6.8 l (CI 1.8, 26)) and transfer (OR 7.5 (CI 1.2, 46)). Those @entity1 receiving only oral antibiotics (OR 3.2 (CI 1.1, 9.7)) were more likely to be cured. Length of therapy >1 week was also associated with cure (OR 2.9 (CI 1.0, 8.6)). Providers with Certificate of Added Qualifications (CAQ) in Geriatric Medicine were more likely to achieve cure (OR 3.1 (CI 1.0, 9.0)). CONCLUSIONS: Most @entity1 with NHAP had diagnostic CXRs and physical examinations. In multivariate analysis, @entity204 was more likely to occur in @entity1 with @entity73 . Cure was associated with the use of oral antibiotics alone and with care by providers with CAQ in Geriatric Medicine.

Provider practice patterns in nursing home-acquired XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'PARTICIPANTS'] @entity73 :: ('MESH:D003072', 'Disease') :: ['cognitive or functional decline', 'Cognitive decline'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity55 :: ('MESH:D011014', 'Disease') :: ['pneumonia', 'Pneumonia']
@entity55 :: (MESH:D011014,Disease) :: ['pneumonia']
