A survey on hospitalised community-acquired pneumonia in Italy

A survey on hospitalised community-acquired pneumonia in Italy

Community Acquired Pneumonia (CAP) remains a major cause of disease and death. We evaluated the levels of care, the outcome and the characteristics of hospitalised patients with CAP in a primary hospital in Italy. We also investigated the value of both the Pneumonia Severity Index (PSI) and the modi...

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Bibliographic Details
Published in:Monaldi archives for chest disease Vol. 65; no. 2; pp. 82 - 88
Main Authors: Migliorati, P L, Boccoli, E, Bracci, L S, Sestini, P, Melani, A S
Format: Journal Article
Language:English
Published: Italy 01-06-2006
Subjects:
Adolescent
Adult
Aged
Analysis of Variance
Community-Acquired Infections - epidemiology
Female
Hospitalization
Humans
Italy - epidemiology
Length of Stay
Male
Middle Aged
Pneumonia - epidemiology
Pneumonia - mortality
Prospective Studies
Retrospective Studies
Risk Factors
Surveys and Questionnaires
Survival Rate
Italy
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Summary:Community Acquired Pneumonia (CAP) remains a major cause of disease and death. We evaluated the levels of care, the outcome and the characteristics of hospitalised patients with CAP in a primary hospital in Italy. We also investigated the value of both the Pneumonia Severity Index (PSI) and the modified Appropriateness Evaluation Protocol (AEP) for recognising both the outcome and the unnecessary admissions and stay of hospitalised patients with CAP. A retrospective review of all the charts of adult patients with CAP at Manerbio, Brescia, Italy between January 2001 and December 2002 was performed. We evaluated 148 patients; their mean age (+/-SD) was 70 (+/-17) years; 34% were female. Most patients (87%) had at least a concomitant co-morbid disease. The overall survival rate at 30 days was 88%. All but one death occurred in the high-risk group of patients according to the PSI. On the contrary, the death rate of patients with inappropriate hospital admission according to the AEP was high. Patients with high PSI score had a significantly longer hospital length of stay than the low-risk group. However, a substantial part of the hospital stay did not show any justification into the charts. The PSI, but not the AEP, upon hospital admission, was useful for evaluating the outcome of patients with CAP. The PSI score and the modified AEP can be useful for assessing the appropriateness of hospitalisation for patients with CAP. There is the need for a practical and validated tool to support physicians in their decision making regarding the early and safe discharge of hospitalised patients with CAP.
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ISSN:1122-0643
DOI:10.4081/monaldi.2006.569