Η πνευμονία της κοινότητας σε γενικό επαρχιακό νοσοκομείο
Managing community - Acquired pneumonia in a county General Hospital
SubjectCommunity-aquired pneumonia ; Pneumonia -- Patients -- Hospital care -- Standards ; Medical protocols ; Πνεύμονες -- Ασθένειες ; Νοσοκομειακή περίθαλψη
Community-Acquired Pneumonia (CAP) is the foremost cause of death due to an infectious aetiology worldwide. CAP affects more than 4 million adults and accounts for more than 1 million hospital admissions each year in the United States. Knowledge of current processes of care is a basic requirement for improving the quality of medical treatment for patients with CAP. A number of different prediction rules and guidelines have been developed to assess severity and prognosis in patients with CAP. The main purpose of this research is the study of the utilization of prediction criteria for hospitalization in Greece. An observational cohort study of patients fulfilling the definition of CAP, was conducted at the General Hospital of Agrinio, during the period between January 2006 and May 2007. A total of 65 patients were included. The analysis showed that 24,6% of patients were classified as 0 CURB65 score, 20% as 1, 27,7% as 2, 9,2% as 3, 13,8% as 4 and 4,6% as 5 CURB65. A new severity score, CXR score, which measures the severity in chest radiographs is defined. Furthermore, the study proves a statistically significant correlation between mortality and CURB65, length of hospital stay and CURB65, CXR score and length of hospital stay. Additionally, a significant inverse correlation between length of hospitalization and hemoglobin A levels is outlined. The scores can be used as evidence based aid for the decision where to treat patients with CAP.