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Community-acquired pneumonia management in a short-stay unit: analysis of safety and efficacy

Juan Pastor A, Jacob J, Llopis Roca F, Gómez-Vaquero C, Ferré Losa C, Pérez Mas JR, Palom Rico X, Giol J, Ramón JM, Salazar Soler A, Corbella Virós X

Servicio de Urgencias y Unidad de Corta Estancia. Servicio de Reumatología. Servicio de Medicina Preventiva. Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat. Barcelona, Spain.

Background and objective: Community-acquired pneumonia (CAP) is a highly
prevalent disease that often requires hospital admission. We aimed to assess the safety
and efficacy of treating CAP in a short-stay unit as an alternative to conventional
Methods: Retrospective comparison of patients admitted to a tertiary care hospital with
a diagnosis of CAP between November 2005 and April 2007. We compared outcomes
for cases managed in the 2 locations (short-stay unit vs conventional hospital ward),
excluding patients who required intensive care. Variables and outcomes analyzed were
age, sex, Charlson index, mean weight in the diagnosis-related group, scores on the
CURB-65 criteria and the Pneumonia Severity Index (PSI), findings of microbiology, and
readmission and mortality rates.
Results: A total of 606 patients were studied; 187 were treated in the short-stay unit and
419 were admitted to the conventional ward. The main significant differences between
the 2 groups were mean age (77.3 vs 67.9 years, respectively; P<.0001) and mean stay
(3.48 vs 7.89 days; P<.0001). These differences were also reflected in the comparison
between severity subgroups (by PSI). Mortality rates did not differ.
Conclusions: Our experience with the short-stay unit suggests it offers a safe and
effective way to manage CAP and leads to a significantly shorter hospital stay in
comparison with conventional hospitalization, without increasing readmission and
mortality rates.

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