Linked Life Data

8731572

Source:http://linkedlifedata.com/resource/pubmed/id/8731572

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
6
pubmed:dateCreated
1996-12-6
pubmed:abstractText
To evaluate the admission criteria and to select indicators that identify patients for whom hospitalization is not necessary, we studied 75 patients with community acquired pneumonia (CAP) who were admitted to a clinical service. According to Appropriateness Evaluation Protocol (AEP) only 60% of our patients justified their hospitalization (Group A) while 40% did not (Group B). The most frequent hospitalization criteria found in Group A were tachypnea (> 30x min.) (40%), respiratory failure (38%) and encefalopathy (18%). The average age in Group A was 62 versus 47 in Group B (p < 0.001). Comorbid conditions were present in 100% of Group A and 71% had two or more while only 33% of patients in Group B had two or more (p < 0.01). During the evolution, Group A had more organ failure than B (53 vs. 17%) (p < 0.001) and a longer period of hospitalization (14 vs. 9 days) (p < 0.01). The differences between groups A and B is best visualized in the incidence of sepsis (4 vs. 0%), and mortality rates (15% vs. 0%) (p < 0.05). Using the Fine risk criteria for a complicated course, we selected 14 patients from Group B, with one or more criteria (Group C) that were compared with 16 patients without them (Group D). The presence of a poor clinical status at admission was the only difference between Group D and C (79 vs. 0%) (p < 0.001). When three or more risk factors were present the differences were significant (79 vs. 6%) (p < 0.001). We conclude that the utilization of hospitalization criteria together with the risk factors for a complicated course, specifically when two or more factors per patient are present, permit the identification of a population with CAP that needs hospitalization with 71.4% sensitivity and 100% specificity. The presence of two or less risk factors in patients without admission criteria has a highly predictable negative value (100%) and anticipates an uneventful evolution without complications.
pubmed:language
spa
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:issn
0025-7680
pubmed:author
pubmed:issnType
Print
pubmed:volume
55
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
641-6
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed:year
1995
pubmed:articleTitle
[Community-acquired pneumonias. Admission criteria and complicated course indicators].
pubmed:affiliation
Cátedra de clínica Médica II, Universidad Nacional de Cuyo, Mendoza.
pubmed:publicationType
Journal Article, English Abstract