Neumonía adquirida en la comunidad que requiere ingreso hospitalario. Una comparación del manejo clínico, consumo de recursos y pronóstico entre diferentes especialidades médicas

Abstract

To evaluate whether there are differences regarding therapy, resource use and prognosis of inpatients due to community acquired pneumonia (CAP) in different clinical departments. One-year retrospective study, using the discharge abstract, of all patients aged over 7 years admitted to the general hospital with the diagnosis of CAP. Comparison of the appropriateness of antibiotic therapy, mean hospital stay, use of invasive procedures, intrahospital mortality rate, and readmissions between the different clinical departments. A total of 511 patients were studied, 154 in Internal Medicine, 197 in Pneumology, 107 in Geriatrics and 53 in other departments, with moderate to severe underlying disease in 50.8%, severity criteria of CAP in 75%, and intrahospital mortality rate of 11.7%. No differences were observed regarding mean stay or appropriateness of antibiotic therapy. Invasive procedures were used most commonly in the Pneumology Department (12% vs 2%-7.5%; p = 0.001). In the Geriatrics Department readmissions were most common (10% vs 1%-4%; p = 0.006) and intrahospital mortality rate (19% vs 8.6%-13.2%; p = 0.029) than in the remaining departments. Intrahospital mortality was associated with a moderate or severe underlying disease, neurologic disease, severity criteria of CAP and ICU admission, and readmissions with a moderate or severe underlying disease. There are relevant differences in intrahospital mortality rate and readmissions among patients with CAP in the different clinical departments, which seem to be associated with the underlying disease and the severity of the CAP.