Patients with community-acquired pneumonia who are at low risk for short-term mortality can be identified using a validated prediction rule, the Pneumonia Severity Index.
Such patients should be candidates for outpatient treatment, yet many are hospitalized.
To assess a program to safely increase the proportion of low-risk patients with pneumonia treated at home.
The intervention provided physicians with the Pneumonia Severity Index score and corresponding mortality risk for eligible patients and offered enhanced visiting nurse services and the antibiotic clarithromycin.
Prospectively enrolled, consecutive low-risk patients with pneumonia presenting to an emergency department during the intervention period (n=166) were compared with consecutive retrospective controls (n=147) identified during the prior year.
A second group of 208 patients from the study hospital who participated in the Pneumonia Patient Outcomes Research Team cohort study served as controls for patient-reported measures of recovery.
There were no significant baseline differences between patients in the intervention and control groups.
The percentage initially treated as outpatients increased from 42% in the control period to 57% in the intervention period (36% relative increase ; 95% confidence interval, 8% - 72% ; P=01).
However, more outpatients during the intervention period were subsequently admitted to the study hospital (9% vs 0%). (...)
Mots-clés Pascal : Pneumonie, Communauté, Etude cohorte, Traitement, A domicile, Campagne de masse, Facteur sécurité, Evaluation, Homme, Appareil respiratoire pathologie, Poumon pathologie, Organisation santé
Mots-clés Pascal anglais : Pneumonia, Community, Cohort study, Treatment, At home, Mass campaign, Safety factor, Evaluation, Human, Respiratory disease, Lung disease, Public health organization
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0312809
Code Inist : 002B11D. Création : 27/11/1998.