{"created":"2021-03-01T06:40:16.372626+00:00","id":33824,"links":{},"metadata":{"_buckets":{"deposit":"98afc38c-6c61-4f8d-b26b-b6c8da1e0ddc"},"_deposit":{"id":"33824","owners":[],"pid":{"revision_id":0,"type":"depid","value":"33824"},"status":"published"},"_oai":{"id":"oai:niigata-u.repo.nii.ac.jp:00033824","sets":["453:456","471:537:538:1999"]},"item_7_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2019-03","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"3","bibliographicPageEnd":"113","bibliographicPageStart":"109","bibliographicVolumeNumber":"133","bibliographic_titles":[{"bibliographic_title":"新潟医学会雑誌"},{"bibliographic_title":"NIIGATA MEDICAL JOURNAL","bibliographic_titleLang":"en"}]}]},"item_7_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"　高齢者に関しては生存・死亡の有無だけでなく，ADLを保ち，健康寿命を延ばすかが重要となる．高齢者の肺炎は，予後不良であり， ADL低下を起こすことが示されている．高齢者肺炎の予後改善のために，超高齢社会である地城病院での，肺炎治療の現状を調査し， ADLがどのように影響するかを検討した．\n　高齢化率が高い新潟県内2つの病院の新規の医療介護肺炎入院患者612例（年齢中央値87歳）において，①高齢者NHCAP入院症例の治療アウトカム，②入院前のADLと初回肺炎死亡率，③リハビリ介入の有無による初回肺炎死亡率をレトロスペクティプに検討した．\n　初回肺炎死亡率は9.6%, 30日死亡率は18.1%であった．使用抗菌薬スペクトラムと死亡率には関連がみられなかった．一方で，入院前ADL毎（障害高齢者の日常生活自立度を使用）の，初回肺炎死亡率では，自立0%, 室内歩行4.3%, 車いす9.6%, 寝たきり15.9%と，ADLが低下するほど高い傾向があった．年齢・性別・入院前ADL・併存症・ADROPの重症度算定項目（年齢・脱水・SpO2・意識障害・血圧低下）を用いた傾向スコアマッチング後に，リハビリ介入群と非介入群で2群にわけ(N=l85例），初回肺炎死亡率を比較した結果，リハビリ介入群では1.6%で，非介入群18.4%と比較して有意に低かった(p<0/01).\n　高齢者肺炎の予後の改善には，抗菌薬加療だけではなく，ADLの維持が重要である．入院前のADLを維持することはもちろん，入院後も早のリハビリ介入等でADLの維持を図る必要がある．","subitem_description_type":"Abstract"}]},"item_7_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"58299","nameIdentifierScheme":"WEKO"}],"names":[{"name":"KOIZUMI, Takeshi"}]}]},"item_7_publisher_7":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"新潟医学会"}]},"item_7_select_19":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_select_item":"publisher"}]},"item_7_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AA00182415","subitem_source_identifier_type":"NCID"}]},"item_7_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"00290440","subitem_source_identifier_type":"ISSN"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"小泉, 健"}],"nameIdentifiers":[{"nameIdentifier":"50983","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2020-04-24"}],"displaytype":"detail","filename":"133（3）_109_3.pdf","filesize":[{"value":"3.4 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"133（3）_109_3","url":"https://niigata-u.repo.nii.ac.jp/record/33824/files/133（3）_109_3.pdf"},"version_id":"8fd22440-ce70-4508-a1ea-0d2aad3cf9c4"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"医療介護関連肺炎","subitem_subject_scheme":"Other"},{"subitem_subject":"障害高齢者の日常生活自立度","subitem_subject_scheme":"Other"},{"subitem_subject":"ADL","subitem_subject_scheme":"Other"},{"subitem_subject":"誤嚥性肺炎","subitem_subject_scheme":"Other"},{"subitem_subject":"初回肺炎死亡率","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"3 超高齢社会における肺炎入院患者の治療アウトカム : 地域病院での肺炎治療の現状 (シンポジウム 感染症研究の新たな展開, 第734回新潟医学会)","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"3 超高齢社会における肺炎入院患者の治療アウトカム : 地域病院での肺炎治療の現状 (シンポジウム 感染症研究の新たな展開, 第734回新潟医学会)"},{"subitem_title":"The Treatment Outcome of Pneumonia in Patients in the Society of the Aged : The Situation in the Community Medical Organization","subitem_title_language":"en"}]},"item_type_id":"7","owner":"1","path":["456","1999"],"pubdate":{"attribute_name":"公開日","attribute_value":"2020-04-24"},"publish_date":"2020-04-24","publish_status":"0","recid":"33824","relation_version_is_last":true,"title":["3 超高齢社会における肺炎入院患者の治療アウトカム : 地域病院での肺炎治療の現状 (シンポジウム 感染症研究の新たな展開, 第734回新潟医学会)"],"weko_creator_id":"1","weko_shared_id":2},"updated":"2022-12-15T04:04:04.601826+00:00"}