Evaluation of hospital admission criteria for community acquired-pneumonia patients at a private hospital in UAE

Abstract

Background/AimPneumonia is one of the most common causes of morbidity and mortality worldwide. From a pharmacoeconomic point of view, it is better for patients with pneumonia who do not need hospitalization to be seen as out-patients; as soon as they are cured they can return to their work right away. The aim of this study is to evaluate the diagnostic and therapeutic procedures used to assess CAP patients and assess of the severity of CAP patients and the need for hospitalization. MethodsA retrospective descriptive and comparative study of all patients suffering from CAP. Revision of archives files of the hospital in the period between 1st of December 2007 and 30th November 2012 which includes 403 patients' files. The evaluation of admission criteria was carried out according to the CURB-65 model for severity assessment. ResultsFour hundred and three patients were evaluated (277 males and 129 females) with variations in population age (P = 0.0001; toward lower age "95% CI" using one sample T test), of those only 35 cases (8.6%) were found to have all the criteria available for implementing the CURB-65 model; from those 10 (37%) out of 27 low risk patients were admitted and 1 (12.5%) out of 8 high risk patients was treated as an out-patient. The mean respiratory rate was low (23 bpm) with a significant difference toward children (P = 0.0001; 95% CI) using one way ANOVA. The mean urea level was high (9.4 mmol/l) with a significant difference toward the elderly (P = 0.0001; 95% CI) using one sample T test. Other factors that are needed for the effective use of the model were also evaluated like FBC, SO2, sputum and microbiological investigation. Monotherapy was the choice for (77%) of the cases. ConclusionThis study concludes that CURB-65 is not utilized in the way it should be when dealing with pneumonia patients. It is recommended that hospital administrations take action in the follow up process in order to prevent individual decisions made by physicians.