TY - JOUR
T1 - Elderly patients with community-acquired pneumonia are not treated according to current guidelines
AU - Lindhardt Damsgaard, Tove
AU - Klausen, Henrik Hedegaard
AU - Christiansen, Christina
AU - Lawson-Smith, Louise
AU - Petersen, Janne
AU - Andersen, Ove
PY - 2013
Y1 - 2013
N2 - INTRODUCTION: Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality in elderly patients, and the most important cause of death in the developed world. Optimised treatment and care will benefit patients as well as the health economy. This study investigates inhospital compliance with guidelines for treatment and care of patients with CAP. MATERIAL AND METHODS: A retrospective nationwide study examining 100 patient records from 20 Danish hospitals regarding patients 65 years and older admitted for CAP. RESULTS: A total of 74 patients with a mean age 81.6 years were included. The mean length of stay was 9.2 days, 30- and 90-day mortality rates were 12.2 and 17.6% and readmission rates 4% (seven days) and 9.5% (30 days). Severity assessment was made in two cases. Observations of vital parameters were unsystematic and the respiratory rate was measured only in six cases. Diagnostic tests and treatment initiation were mostly in accordance with guidelines. The mean number of days on intravenous antibiotics was 5.5. Nutrition and mobilisation were neglected or only sporadically addressed. No systematic plan for treatment and care was found. CONCLUSIONS: While medical treatment mainly concurred with guidelines, a potential for reduced costs by early discharge planning and use of systematic assessment tools for site-of-care and treatment decisions was indicated. The lack of systematic interventions in the prevention and treatment of malnutrition and functional decline constitutes a threat to a success-ful final patient outcome. FUNDING: The Danish Ministry of Health funded the study. TRIAL REGISTRATION: The Danish Data Register approved the project (J. No. 2010-41-5358).
AB - INTRODUCTION: Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality in elderly patients, and the most important cause of death in the developed world. Optimised treatment and care will benefit patients as well as the health economy. This study investigates inhospital compliance with guidelines for treatment and care of patients with CAP. MATERIAL AND METHODS: A retrospective nationwide study examining 100 patient records from 20 Danish hospitals regarding patients 65 years and older admitted for CAP. RESULTS: A total of 74 patients with a mean age 81.6 years were included. The mean length of stay was 9.2 days, 30- and 90-day mortality rates were 12.2 and 17.6% and readmission rates 4% (seven days) and 9.5% (30 days). Severity assessment was made in two cases. Observations of vital parameters were unsystematic and the respiratory rate was measured only in six cases. Diagnostic tests and treatment initiation were mostly in accordance with guidelines. The mean number of days on intravenous antibiotics was 5.5. Nutrition and mobilisation were neglected or only sporadically addressed. No systematic plan for treatment and care was found. CONCLUSIONS: While medical treatment mainly concurred with guidelines, a potential for reduced costs by early discharge planning and use of systematic assessment tools for site-of-care and treatment decisions was indicated. The lack of systematic interventions in the prevention and treatment of malnutrition and functional decline constitutes a threat to a success-ful final patient outcome. FUNDING: The Danish Ministry of Health funded the study. TRIAL REGISTRATION: The Danish Data Register approved the project (J. No. 2010-41-5358).
M3 - Journal article
SN - 2245-1919
VL - 60
SP - A4572
JO - Danish Medical Journal
JF - Danish Medical Journal
IS - 2
ER -
