Community-acquired pneumonia management in a short-stay unit: analysis of safety and efficacy

Abstract

Background and objective: Community-acquired pneumonia (CAP) is a highly prevalent disease that often requires hospital admission. We aimed to assess the safety and efficacy of treating CAP in a short-stay unit as an alternative to conventional hospitalization. Methods: Retrospective comparison of patients admitted to a tertiary care hospital with a diagnosis of CAP between November 2005 and April 2007. We compared outcomes for cases managed in the 2 locations (short-stay unit vs conventional hospital ward), excluding patients who required intensive care. Variables and outcomes analyzed were age, sex, Charlson index, mean weight in the diagnosis-related group, scores on the CURB-65 criteria and the Pneumonia Severity Index (PSI), findings of microbiology, and readmission and mortality rates. Results: A total of 606 patients were studied; 187 were treated in the short-stay unit and 419 were admitted to the conventional ward. The main significant differences between the 2 groups were mean age (77.3 vs 67.9 years, respectively; P<.0001) and mean stay (3.48 vs 7.89 days; P<.0001). These differences were also reflected in the comparison between severity subgroups (by PSI). Mortality rates did not differ. Conclusions: Our experience with the short-stay unit suggests it offers a safe and effective way to manage CAP and leads to a significantly shorter hospital stay in comparison with conventional hospitalization, without increasing readmission and mortality rates.