Outpatient Treatment And Community Acquired Pneumonia (CAP): A Comparative Study With Hospital Admission

2011 ◽  
Author(s):  
Jose N. Sancho-Chust ◽  
Eusebi Chiner ◽  
Jose Blanquer ◽  
Francisco Sanz ◽  
Estrella Fernandez-Fabrellas ◽  
...  
Keyword(s):  
Comparative Study ◽  
Hospital Admission ◽  
Outpatient Treatment ◽  
Community Acquired Pneumonia

scholarly journals The effect of air temperature on hospital admission of adults with community acquired pneumonia in Baotou, China

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wenfang Guo ◽  
Letai Yi ◽  
Peng Wang ◽  
Baojun Wang ◽  
Minhui Li
Keyword(s):  
Hospital Admission ◽  
Air Temperature ◽  
Meteorological Data ◽  
Community Acquired Pneumonia ◽  
Adult Patients ◽  
Distributed Lag ◽  
Specific Effects ◽  
Lower Temperature Range ◽  
Lower Temperature ◽  
Inner Mongolia Autonomous Region

AbstractThe relationship between air temperature and the hospital admission of adult patients with community-acquired pneumonia (CAP) was analyzed. The hospitalization data pertaining to adult CAP patients (age ≥ 18 years) in two tertiary comprehensive hospitals in Baotou, Inner Mongolia Autonomous Region, China from 2014 to 2018 and meteorological data there in the corresponding period were collected. The exposure–response relationship between the daily average temperature and the hospital admission of adult CAP patients was quantified by using a distributed lag non-linear model. A total of 4466 cases of adult patients with CAP were admitted. After eliminating some confounding factors such as relative humidity, wind speed, air pressure, long-term trend, and seasonal trend, a lower temperature was found to be associated with a higher risk of adult CAP. Compared to 21 °C, lower temperature range of 4 to –12 °C was associated with a greater number of CAP hospitalizations among those aged ≥ 65 years, and the highest relative risk (RR) was 2.80 (95% CI 1.15–6.80) at a temperature of − 10 °C. For those < 65 years, lower temperature was not related to CAP hospitalizations. Cumulative lag RRs of low temperature with CAP hospitalizations indicate that the risk associated with colder temperatures appeared at a lag of 0–7 days. For those ≥ 65 years, the cumulative RR of CAP hospitalizations over lagging days 0–5 was 1.89 (95% CI 1.01–3. 56). In brief, the lower temperature had age-specific effects on CAP hospitalizations in Baotou, China, especially among those aged ≥ 65 years.

scholarly journals GP management of community-acquired pneumonia in Italy: the ISOCAP study

2005 ◽  
Vol 63 (1) ◽  
Author(s):  
C.M. Sanguinetti ◽  
F. De Benedetto ◽  
C.F. Donner
Keyword(s):  
Outpatient Treatment ◽  
The Elderly ◽  
Community Acquired Pneumonia ◽  
Microbiological Analysis ◽  
X Ray ◽  
Systemic Arterial Hypertension ◽  
Chest X Ray ◽  
Socioeconomic Burden ◽  
Copd Diagnosis ◽  
Observation Period

Background. Community-Acquired Pneumonia (CAP) is still a significant problem in terms of incidence, mortality rate, particularly in infants and the elderly, and socioeconomic burden. General Practitioners (GPs) are the first reference for patients with this disease, but there are few published studies regarding the outpatient treatment of CAP. Methods. The ISOCAP study aimed to identify the type and outcome of the diagnostic-therapeutic management of CAP by GPs in Italy, within the framework of developing a closer interrelationship between GPs and pulmonary specialists. Thirty-six Pulmonary Divisions throughout Italy each contacted 5 local GPs who agreed to recruit the first 5 consecutive patients who consulted them for suspected CAP within the study’s 1-year observation period. Results. A total of 183 GPs took part in the study and enrolled, by the end of the observation period, 763 CAP patients; of these, complete data was available for 737 patients [males=373, females=364, mean age (±SD) 58.8±19.6 years]. 64.4% of patients had concomitant diseases, mainly systemic arterial hypertension and COPD. Diagnosis of CAP was based by GPs on physical examination only in 41.6% of cases; in the remaining chest X-ray was also performed. In only 4.6% of patients were samples sent for microbiological analysis. All patients were treated with antibiotics: 76.7% in mono-therapy, 23.3% with a combination of antibiotics. The antibiotic class most prevalently used in mono-therapy was cephalosporin, primarily ceftriaxone; the most frequently used combinations were cephalosporin+macrolide and cephalosporin+quinolone. Mono-therapy was effective in 70% of cases, the combination of two or more antibiotics in 91.2% of patients. Overall treatment efficacy was 94.7%; hospitalisation was required in 8.5% of cases. Conclusions. Outpatient management of CAP by GPs in Italy is effective, hospitalisation being necessary only in the most severe cases due to age, co-morbidities or extent of pneumonia. This signifies a very significant savings in national health costs.

A Comparative Study of Results in Neurotic Patients Treated by Two Different Methods

1954 ◽  
Vol 100 (420) ◽  
pp. 718-721 ◽  
Author(s):  
Arthur Harris
Keyword(s):  
Environmental Factors ◽  
Comparative Study ◽  
General Practitioners ◽  
Outpatient Treatment ◽  
Medical Staff ◽  
Waiting Lists ◽  
Outpatient Department ◽  
Number Of Patients ◽  
Hospital Patients ◽  
Constant Source

In the outpatient department of the Maudsley Hospital, patients are seen in the first instance by members of the medical staff of consultant status at the diagnostic clinics, to which they are referred from a variety of sources, by far the greater number coming from general practitioners. From the diagnostic clinics there are several possible disposals, one of which is referral for outpatient treatment of a more prolonged and elaborate type, as opposed to treatment at a purely supportive level with brief interviews concerned with environmental factors and immediate practical problems. The more prolonged and elaborate outpatient treatment is under the supervision of a physician of consultant status with a Freudian analytical training and strong interest in psychotherapeutic methods. It is carried out by registrars under his guidance and may consist either of individual or group sessions, or of a mixture of the two, as he directs. His general outlook is well known (Foulkes, 1948). It has been a constant source of difficulty that the number of patients referred for this type of outpatient treatment has been greater than the resources of the hospital could manage, with the consequent development of long waiting lists and of the necessity for making awkward decisions with regard to priorities.

scholarly journals Health Care-Associated Pneumonia and Community-Acquired Pneumonia: a Single-Center Experience

2007 ◽  
Vol 51 (10) ◽  
pp. 3568-3573 ◽  
Author(s):  
Scott T. Micek ◽  
Katherine E. Kollef ◽  
Richard M. Reichley ◽  
Nareg Roubinian ◽  
Marin H. Kollef
Keyword(s):  
Health Care ◽  
Staphylococcus Aureus ◽  
Hospital Mortality ◽  
Hospital Admission ◽  
Health Care Providers ◽  
Community Acquired Pneumonia ◽  
Antimicrobial Treatment ◽  
Care Providers ◽  
Health Care Associated Pneumonia ◽  
Culture Positive

ABSTRACT Pneumonia occurring outside of the hospital setting has traditionally been categorized as community-acquired pneumonia (CAP). However, when pneumonia is associated with health care risk factors (prior hospitalization, dialysis, residing in a nursing home, immunocompromised state), it is now more appropriately classified as a health care-associated pneumonia (HCAP). The relative incidences of CAP and HCAP among patients requiring hospital admission is not well described. The objective of this retrospective cohort study, involving 639 patients with culture-positive CAP and HCAP admitted between 1 January 2003 and 31 December 2005, was to characterize the incidences, microbiology, and treatment patterns for CAP and HCAP among patients requiring hospital admission. HCAP was more common than CAP (67.4% versus 32.6%). The most common pathogens identified overall included methicillin-resistant Staphylococcus aureus (24.6%), Streptococcus pneumoniae (20.3%), Pseudomonas aeruginosa (18.8%), methicillin-sensitive Staphylococcus aureus (13.8%), and Haemophilus influenzae (8.5%). The hospital mortality rate was statistically greater among patients with HCAP than among those with CAP (24.6% versus 9.1%; P < 0.001). Administration of inappropriate initial antimicrobial treatment was statistically more common among HCAP patients (28.3% versus 13.0%; P < 0.001) and was identified as an independent risk factor for hospital mortality. Our study found that the incidence of HCAP was greater than that of CAP among patients with culture-positive pneumonia requiring hospitalization at Barnes-Jewish Hospital. Patients with HCAP were more likely to initially receive inappropriate antimicrobial treatment and had a greater risk of hospital mortality. Health care providers should differentiate patients with HCAP from those with CAP in order to provide more appropriate initial antimicrobial therapy.

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