Does early review by a respiratory physician lead to a shorter length of stay for patients with non-severe community-acquired pneumonia?
Does early review by a respiratory physician lead to a shorter length of stay for patients with non-severe community-acquired pneumonia?
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DOI：
10.1136/thx.2008.109983
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发表时间：
2009-08-01
期刊：
影响因子：
10
通讯作者：
Lim, W. S.
中科院分区：
文献类型：
--
作者：
Bewick, T.;Cooper, V. J.;Lim, W. S.
背景：本研究的目的是评估非严重社区获得性肺炎（CAP）患者最初由呼吸内科医生就诊时是否比由非呼吸内科医生就诊时住院时间（LOS）更短。方法：在诺丁汉市医院，按照护士分诊，病情不严重的急症患者被送入顾问领导的急诊短期住院病房（ESSU）。回顾性研究了2004年1月至2007年12月期间在esu就诊的与CAP相关的临床出院代码的患者记录。同一时期诊断为蜂窝织炎的患者作为对照。患者分组取决于他们是否在第一次就诊后由呼吸咨询医生（a组），非呼吸咨询医生（B组）或周六或周日（C组）就诊。结果：经排除，共纳入426例CAP患者和935例蜂窝织炎患者。A组CAP患者的中位生存时间为1.74天（n = 123，四分位间距（IQR） 0.97-4.09）， B组为3.03天(n = 174, IQR 1.12-6.23
Background: The aim of this study was to evaluate whether patients with non-severe community-acquired pneumonia (CAP) have a shorter length of stay (LOS) when initially seen by a respiratory physician compared with a non-respiratory physician.Methods: At Nottingham City Hospital, following nurse triage, acute medical patients who are not severely ill are admitted to the consultant-led emergency short stay unit (ESSU). Records of patients seen on ESSU between January 2004 and December 2007 with a clinical discharge code relating to CAP were retrospectively examined. Patients with a diagnosis of cellulitis over the same time period were used as controls. Patients were grouped depending on whether they were seen on their first post-take ward round by a respiratory consultant physician (group A), non-respiratory consultant physician (group B) or on a Saturday or Sunday (group C).Results: Following exclusions, 426 patients with CAP and 935 patients with cellulitis were analysed. The median LOS for patients with CAP in group A was 1.74 days (n = 123, interquartile range (IQR) 0.97-4.09) compared with 3.03 days for patients in group B (n = 174, IQR 1.12-6.23; p