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Original Research

Open Access

Influence of the adequacy of data collection, during two years, in the management of community acquired pneumonia in emergency departments

  • RIMBAU P1
  • PERELLÓ R2
  • GOMEZ VAQUERO C3
  • SAUBÍ N4
  • MIRÓ O2
  • JUAN PASTOR A5

1Emergency Department, Hospital J Trueta, Girona

2 Emergency Department Servicio de Urgencias Hospital Cínic, Barcelona, IDIBAPS

3 Rheumatology Department, Hospital Universitari Bellvitge, Institut Català de la Salut

4 Department of Infectious Diseases, Hospital Clínic, Barcelona

5 Director of Healthcare, Institut Català de la Salut

DOI: 10.22514/SV132.112017.6 Vol.13,Issue 2,November 2017 pp.41-46

Published: 06 November 2017

*Corresponding Author(s): RIMBAU P E-mail: rperello@clinic.ub.es

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Abstract

Objective. The aim of this study was to analyze whether structured data collec-tion of patients with community-acquired pneumonia (CAP) in the Emergency De-partment (ED) improves compliance with clinical guidelines regarding inpatient and outpatient treatment and prescription of antibiotics at discharge. 

Material and methods. We performed a quasi experimental, multicenter, pre/post-intervention study. The intervention con-sisted of basic training for the participat-ing physicians and the incorporation of a data collection sheet in the clinical history chart, including the information neces-sary for adequate decision making re-garding patient admission and treatment, in the case of discharge. We analyzed the adequacy of the final destination of pa-tients classified as Fine I-II and antibiotic treatment in patients receiving outpatient treatment, with each participating physi-cian including 8 consecutive patients (4 pre-intervention and 4 post-intervention). Results. A total of 738 patients were in-cluded: 378 pre-intervention and 360 post-intervention. In the pre-intervention group, Fine V was more frequent and pa-tients were older, had more ischemic heart disease, active neoplasms and fewer risk factors for atypical pneumonia. Of the patients with Fine I-II, 23.7% were in-adequately admitted and 19.6% of those discharged received treatment not rec-ommended by guidelines. No differences were observed in the target variables be-tween the two groups. Conclusion. The adequacy of the decision to admit patients with Fine I-II CAP and outpatient antibiotic treatment can be im-proved in the ED. Structured data collec-tion does not improve patient outcome. 

Keywords

community-acquired pneu-monia, emergency department, antibiotic treatment, adequacy of admission 

Cite and Share

RIMBAU P,PERELLÓ R,GOMEZ VAQUERO C,SAUBÍ N,MIRÓ O,JUAN PASTOR A. Influence of the adequacy of data collection, during two years, in the management of community acquired pneumonia in emergency departments. Signa Vitae. 2017. 13(2);41-46.

URL:

https://www.signavitae.com/articles/10.22514/SV132.112017.6

References

1. Menéndez R, Torres A, Aspa J, Capelastegui A, Prat C, Rodríguez de Castro F. neumonía adquirida en la comunidad. Nueva norma-tive de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR). Arch Bronconeumol 2010;46:543-58.

2. Sicras-Mainar A, Ibáñez-Nolla J, Cifuentes I, Guijarro P, Navarro-Artieda R, Aguilar L. Retrospective epidemiological study for the characterization of community-acquiered pneumonia and pneumococcal pneumonia in adults in a well-defined area of Badalona (Barcelona, Spain). BMC Infect Dis 2012;12:283. doi:10.1186/1471-2334-12-283.

3. Julián-Jiménez A, González del Castillo J, Candel González FJ. When, where and how should a patient with community acquired pneumonia be admitted? Rev Clín Esp 2013;213:99-107.

4. Fine MJ, Auble TE, Yealy DM, Hanusa BH, Weissfeld LA, Singer DE, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med 1997;336:243-50.

5. Lim WS, Van der Eerden MM, Laing R, Boersma WG, Karalus N, Town GI, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax 2003;58:377-82.

6. Mandell LA, Wunderink Rg, Anzueto A, Bartlett JG, Campbell GD, Dean NC, et al. Infectious Diseases Society of America/Ameri-can Thoracic Society consensos guidelines on the Management of community-acquired pneumonia in adults. Clin Infect Dis 2007;44(Suppl 2):S27-72.

7. Simonetti AF, Viasus D, Garcia-Vidal C, Carratalà. Management of community-acquired pneumonia in older adults. J Ther Adv Infect Dis 2014;2:3-16.

8. Mattila JT, Fine MJ, Limper AH, Murray PR, Chen BB, Lin PL. Pneumonia. Treatment and diagnosis. Ann Am Thorac Soc 2014;11(Suppl 4):S189-92.

9. Julián-Jiménez A, Candel FJ, Piñera P, González del Castillo J, Moya MS, Martínez M. Recomendaciones INFURG-SEMES: manejo de la infección respiratoria de vías respiratorias bajas en urgencias. Monografías de Emergencias 2009;3:1-21.

10. Sibila O, Restrepo MI, Anzueto A. What is the best antimicrobial treatment for severe community-acquired pneumonia (including the role of steroids and statins and other immunomodulatory agents). Infect Dis Clin North Am 2013;27:133-47.

11. Potena A, Simoni M, Cellini M, Cartabellotta A, Ballerin L, Piattella M, et al. Management of community-acquired pneumonia by trained family general practitioners. Int J Tuberc Lung Dis 2008;12:19-25.

12. Julián-Jiménez A, Palomo de los Reyes MJ, Parejo Miguez R, Laín-Terés N, Cuena-Boy R, Lozano-Ancín A. Improved Management of community-acquired pneumonia in the emergency department. Arch Bronconeumol 2013;49:230-40.

13. Bartlett JG, Breiman RF, Mandell LA, File TM, JR. Community-acquiered pneumonia in adults: guidelines for management. The Infectious Diseases Society of America. Clin Infect Dis 1998;26:811-38.

14. Jo S, Kim K, Jung K, Rhee JE, Cho IS, Lee CC, Singer AJ. The effects of incorporating a pneumonia severity index into the admission protocol for Community-acquired pneumonia. J Emerg Med 2012;42:133-8.

15. Miró O, Escalada X, Gené E, Boqué C, Jiménez Fábrega FX, Netto C, et al. Estudio SUHCAT(2): mapa físico de los servicios de ur-gencias hospitalarios de Cataluña. Emergencias 2014;26:19-34.

16. Miró O, Escalada X, Gené E, Boqué C, Jiménez Fábrega FX, Netto C, et al. Estudio SUHCAT(2): mapa funcional de los servicios de urgencias hospitalarios de Cataluña. Emergencias 2014;26:35-46.

17. Miró O, Escalada X, Gené E, Boqué C, Jiménez Fábrega FX, Netto C, et al. Estudio SUHCAT(3): mapa docente e investigador de los servicios de urgencias hospitalarios de Cataluña. Emergencias 2014;26:47-56.

18. Llopis Roca F, Ferré Losa C, Juan Pastor A, Martín Sánchez FJ, Sempere Montes G, Llorens Soriano, et al. Proyecto REGICE. Gestión clínica de las unidades de corta estancia en España (REGICE-2). Emergencias 2014;26:359-62.

19. Llopis Roca F, Ferré Losa C, Juan Pastor A, Martín Sánchez FJ, Sempere Montes G, Llorens Soriano P, et al. Proyecto REGICE. Gestión clínica de las unidades de corta estancia en España (REGICE 2). Emergencias 2014;26:359-62.

20. Aujesky D, McCausland JB, Whittle J, Obrosky DS, Yealy DM, Fine MJ. Reasons why emergency department providers do not rely on the pneumonia severity index to determinate the initial site of treatment for patients with pneumonia. Clin Infect Dis 2009;15;49:100-8.

21. Tripp DG. Did an acute medical assessment unit improve the initial assessment and treatment of community acquired pneumonia-a retrospective audit. N Z Med J 2012;125:60-7.

22. Hinojosa Mena-Bernal J, Hinojosa Mena-Bernal C, González Sarmiento E, Almaráz Gómez A, Martín Santos S, Zapatero Gaviria A. Adecuacy of the admissions and care provided to the patients with community-acquired pneumonia. Rev Clin Esp 2011;211:179-86.

23. Cizza G, Piaggi P, Rother KI, Csako G; Sleep Extension Study Group. Hawthorne effect with transient behavioural and biochemical changes in a randomized controlled sleep extension trial of chronically short-sleeping obese adults: implications for the design and interpretation of clinical studies PLoS One. 2014. 9(8): e104176.

24. Llor C. Can the use of antibiotics be improved in outpatients in Spain. Enferm Infecc Microbiol Clin 2014;32:409-11.

25. Martínez Ortiz de Zárate M, González Del Castillo J, Julián Jiménez A, Piñera Salmerón P, Llopis Roca F, Guardiola Tey JM, et al. Estudio INFURG-SEMES: epidemiología de las infecciones atendidas en los servicios de urgencias hospitalarios y evolución durante la última década. Emergencias 2013;25:368-78.

26. Garau J, Fritsch A, Arvis P, Read RC.Clinical efficacy of moxifloxacin versus comparator therapies for community-acquired pneumo-nia caused by Legionella spp. J Chemother 2010;22:264-6.

27. Hess G, Hill JW, Raut MK, Fisher AC, Mody S, Schein JR. Comparative antibiotic failure rates in the treatment of community-acquired pneumonia: Results from a claims analysis. Adv Ther 2010;27:743-55.

28. Friedman H, Song X, Crespi S, Navaratnam P. comparative analysis of length of stay, total costs and treatment success between in-travenous moxifloxacin 400mg and levofloxacin 750mg among hospitalized patients with community-acquired pneumonia. Value Health 2009;12:1135-43.

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