急性期肺炎患者のリハビリテーションアウトカムによるクラスタリングと患者背景・経過に関する検討—後ろ向きケースコントロール研究

Clustering of patients with acute pneumonia by rehabilitation outcome, patient background, and treatment course: A retrospective case-controlled study

要旨：本研究の目的は，リハビリテーションアウトカム（ADLと身体機能評価）により肺炎患者をクラスタリングし，患者背景と経過について検討することである．対象は，急性期病院に肺炎で入院した患者158名（中央値で85歳）である．方法は，階層クラスター分析を実施し，初期と退院前の前後比較を行った．結果，ADLと身体機能が中等度あるいはそれ以上の患者の多くはリハビリテーションアウトカムが改善するが，身体機能の低下を示す患者も一定数存在した．ADLと身体機能が低い肺炎患者は，終末期の患者とリハビリテーションアウトカムの改善が期待できる患者が混在していることがわかった．

　This study aimed to cluster patients with pneumonia according to their rehabilitation outcomes [activities of daily living (ADL) and physical function assessment] and to examine patient backgrounds and course of treatments. The subjects included 158 patients (median age: 85 years) admitted to an acute care hospital for pneumonia. Hierarchical cluster analysis was conducted to compare the before and after initial assessments and pre-discharge assessment. The results showed that patients with moderate to high ADL ability and physical function exhibited great improvements in rehabilitation outcomes, while some patients showed a decline in physical function. Patients with pneumonia whose ADL ability and physical function were low included a mixture of patients with terminal-stage disease and those whose rehabilitation outcomes were expected to improve.