Abstract
Background: Quality Indicators (QI) for management of pneumonia has not been established. We operate on electronic medical charting and often employ the scoring template for severity assessment of community acquired pneumonia (CAP). The template contains the domestically popular A-DROP system and the Pneumonia Severity Index. However there are no validation studies concerning the influence of such template activation on outcome of patients with CAP.
Objective: We investigated whether the template activation rate could serve as a potential QI by looking into its effects on the duration of hospitalization, duration of intravenous antibiotic therapy and 30-day mortality.
Methods: We conducted a retrospective cohort study in 448 patients with CAP admitted to our hospital from January 2007 to December 2012.
Results: 126 patients belonged to the template-used group (TU) and 322 to the template-free group (TF). Respectively, the mean age was 76.7 and 79.5 years, and 83 (66.0%) and 185 (57.5%) were male. In TU, duration of hospitalization in days was 15.2 and that of intravenous antibiotic therapy was 10.2, whereas these figures were 21.1 and 13.2 respectively for TF. After adjusting for sex, blood culture positivity, pneumonia severity and the presence of delirium, the durations of hospitalization and intravenous antibiotic therapy had shorter tendency among TU. In particular, duration of intravenous antibiotic therapy was significantly shorter (regression coefficient (β): -2.4, 95%CI -4.6 to -0.19, p=0.03).
Conclusions: Our findings indicate that high template activation rate may lead to improvement of prognosis and quality of care of patients with CAP.
- Copyright ©ERS 2015
