Menéndez R, Ferrando D, Vallés J M, Martínez E, Perpiñá M
Service of Pneumology, Hospital Universitario La Fe, Valencia, Spain.
Eur Respir J. 2001 Jul;18(1):151-6. doi: 10.1183/09031936.01.00090001.
The total medical costs of community-acquired pneumonia are directly related to the costs of hospital admission and length of stay. The aim of the present study was to evaluate the reasons for prolonged duration of stay in patients stratified in five risk classes for death, and to identify factors associated with prolonged stay. The study population consisted of 295 patients. According to lower (classes I, II, III) or to higher (classes IV, V) risk, the target duration of hospitalization was set at 5 and 7 days, respectively. The causes of prolonged hospitalization were classified as pneumonia-related, complications, unstable comorbid diseases and nonclinical factors. The overall percentage of patients with appropriate duration of hospitalization was 32%. Causes of prolonged hospitalization were related mainly to pneumonia (32%) from all risk classes. Morbid complications and instability of the underlying illness were greater in class V patients. Nonclinical factors were present in 29.5% of cases. Hypoxaemia, anaemia, hypoalbuminaemia, and complications appearing before 72 h were associated with prolonged hospitalization. The cause of prolonged hospitalization of patients with community-acquired pneumonia is multifactorial, depending mainly on pneumonia and comorbid conditions but there is a large number of unnecessary hospitalization days that could be reduced by improving the efficiency of hospital care.
社区获得性肺炎的总医疗费用与住院费用和住院时间直接相关。本研究的目的是评估分为五个死亡风险等级的患者住院时间延长的原因，并确定与住院时间延长相关的因素。研究人群包括295名患者。根据较低（I、II、III级）或较高（IV、V级）风险，目标住院时间分别设定为5天和7天。住院时间延长的原因分为肺炎相关、并发症、不稳定的合并疾病和非临床因素。住院时间合适的患者总体比例为32%。各风险等级中，住院时间延长的原因主要与肺炎有关（32%）。V级患者的病态并发症和基础疾病的不稳定性更高。29.5%的病例存在非临床因素。低氧血症、贫血、低白蛋白血症以及72小时前出现的并发症与住院时间延长有关。社区获得性肺炎患者住院时间延长的原因是多因素的，主要取决于肺炎和合并症，但存在大量不必要的住院天数，可通过提高医院护理效率来减少。
