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Hospitalización diurna como modelo de atención de salud en pacientes adultos inmunocompetentes con neumonía adquirida en la comunidad / Respiratory day hospital care for immunocompetent adult patients with community-acquired pneumonia
Roldán T, Rosa; Torres P, María Elena; Gallardo M, Daniel; Arias C, Marisol; Saldías P, Fernando.
  • Roldán T, Rosa; Servicio de Salud Metropolitano Norte. Complejo Hospitalario San José. Unidad de Broncopulmonar. CL
  • Torres P, María Elena; Servicio de Salud Metropolitano Norte. Complejo Hospitalario San José. Unidad de Broncopulmonar. CL
  • Gallardo M, Daniel; Servicio de Salud Metropolitano Norte. Complejo Hospitalario San José. Unidad de Broncopulmonar. CL
  • Arias C, Marisol; Servicio de Salud Metropolitano Norte. Complejo Hospitalario San José. Unidad de Broncopulmonar. CL
  • Saldías P, Fernando; Servicio de Salud Metropolitano Norte. Complejo Hospitalario San José. Unidad de Broncopulmonar. CL
Rev. méd. Chile ; 143(4): 467-474, abr. 2015. tab
Article in Spanish | LILACS | ID: lil-747553
ABSTRACT

Background:

Day hospitals can reduce health care costs without increasing the risks of patients with lower respiratory tract infection.

Aim:

To report the experience of a respiratory day hospital care delivered to adult patients with community-acquired pneumonia (CAP) in a public hospital. Material and

Methods:

During the fall and winter of 2011 and 2012, adult patients with CAP of intermediate risk categories were assessed in the emergency room, their severity was stratified according to confusion, respiratory rate, blood pressure, 65 years of age or older (CRB-65) score and the Chilean CAP Clinical Guidelines, and were admitted to the respiratory day hospital.

Results:

One hundred seventeen patients aged 67 ± 16 years, (62% females) with CAP were attended in the respiratory day hospital. Ninety percent had comorbidities, especially chronic obstructive pulmonary disease in 58%, heart disease in 32%, diabetes in 16% and asthma in 13%. Their most important risk factors were age over 65 years in 60%, comorbidities in 88%, failure of antibiotic treatment in 17%, loss of autonomy in 21%, vital sign abnormalities in 60%, mental confusion in 5%, multilobar CAP in 23%, pleural effusion in 15%, hypoxemia in 41% and a serum urea nitrogen over 30 mg/dL in 16%. Patients stayed an average of seven days in the day hospital with oxygen, hydration, chest physiotherapy and third-generation cephalosporins (89%) associated with quinolones (52%) or macrolides (4%). Thirteen patients required noninvasive ventilation, eight patients were hospitalized because of clinical deterioration and three died in hospital.

Conclusions:

Day hospital care reduced hospital admission rates of patients with lower respiratory tract infections.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Pneumonia / Primary Health Care / Immunocompromised Host / Pulmonary Disease, Chronic Obstructive / Day Care, Medical Type of study: Etiology study / Practice guideline / Observational study / Prognostic study / Risk factors Limits: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male Language: Spanish Journal: Rev. méd. Chile Journal subject: Medicine Year: 2015 Type: Article Affiliation country: Chile Institution/Affiliation country: Servicio de Salud Metropolitano Norte/CL

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Full text: Available Index: LILACS (Americas) Main subject: Pneumonia / Primary Health Care / Immunocompromised Host / Pulmonary Disease, Chronic Obstructive / Day Care, Medical Type of study: Etiology study / Practice guideline / Observational study / Prognostic study / Risk factors Limits: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male Language: Spanish Journal: Rev. méd. Chile Journal subject: Medicine Year: 2015 Type: Article Affiliation country: Chile Institution/Affiliation country: Servicio de Salud Metropolitano Norte/CL