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Titolo:
Community-acquired pneumonia - which patients are hospitalised?
Autore:
Stauble, SP; Reichlin, S; Dieterle, T; Leimenstoll, B; Schoenenberger, R; Martina, B;
Indirizzi:
Univ Kliniken Basel, Dept Innere Med, CH-4031 Basel, Switzerland Univ Kliniken Basel Basel Switzerland CH-4031 CH-4031 Basel, Switzerland
Titolo Testata:
SWISS MEDICAL WEEKLY
fascicolo: 13-14, volume: 131, anno: 2001,
pagine: 188 - 192
SICI:
1424-7860(20010407)131:13-14<188:CP-WPA>2.0.ZU;2-V
Fonte:
ISI
Lingua:
ENG
Soggetto:
LOW-RISK PATIENTS; PREDICTION RULE; ADULTS;
Keywords:
community-acquired pneumonia; hospitalisation; outcome;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
13
Recensione:
Indirizzi per estratti:
Indirizzo: Martina, B Univ Kliniken Basel, Dept Innere Med, Petersgraben 4, CH-4031 Basel, Switzerland Univ Kliniken Basel Petersgraben 4 Basel Switzerland CH-4031 d
Citazione:
S.P. Stauble et al., "Community-acquired pneumonia - which patients are hospitalised?", SWISS MED W, 131(13-14), 2001, pp. 188-192

Abstract

Background and objective: Patients with community-acquired pneumonia can be allocated into low and high-risk mortality groups by simple clinical criteria. We studied the value of the stratification for outcome as proposed by Fine, et al. to guide the decision for in-hospital versus outpatient treatment in the emergency department. Patients and methods: We studied demographic data, risk group stratification and decision-making for in-hospital versus outpatient treatment in 101 consecutive medical emergency department patients with community-acquired pneumonia. We also analysed predictive factors for hospitalisation of low-risk patients. We obtained complete 30 day follow-up information. Results: Forty-three of 44 high-risk patients were hospitalised after medical emergency department triage. Twenty-seven (47%) of 57 low-risk patientswere hospitalised as well. Based on routine clinical assessment, hospitalisation of low-risk patients was required for poor medical condition or severe pneumonia (67%), for lack of social support (15%) and for relevant comorbidity (18%). In an univariate analysis, age (p = 0.003), C-reactive protein (p = 0.0006), presence of comorbidity (p = 0.0001), Charlson index (p = 0.0001) and active oral steroid treatment (p = 0.028) were significantly correlated with hospitalisation of low-risk patients. The 30-day mortality rate was 32% in patients allocated to the high-risk group at the time of diagnosis in the emergency department, compared to 0% in low-risk patients. Conclusions: Simple clinical criteria distinguish well between low and high 30-day-mortality risk in patients diagnosed with community-acquired pneumonia. Nevertheless, 47% of low-risk patients require in-hospital treatment. Age, C-reactive protein, presence of comorbidity and steroid treatment aresignificantly correlated with hospitalisation of low-risk patients with community-acquired pneumonia.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/01/20 alle ore 07:28:10