Regalado de Los Cobos José, Aizpuru Barandiaran Felipe, Oceja Barrutieta Esther, de Juan Rodríguez María, Apraiz Ruiz Leire, Altuna Basurto Elena, Gomez Rodríguez de Mendarozqueta Montserrat, López-Picado Amanda, Cia Ruiz Juan Miguel
Unidad de Hospitalización a Domicilio de Vitoria-Gasteiz, Hospital Txagorritxu y Hospital Santiago Apóstol, Vitoria-Gasteiz, España.
Med Clin (Barc). 2010 Jun 12;135(2):47-51. doi: 10.1016/j.medcli.2009.12.021. Epub 2010 May 6.
Different scientific societies propose the use of scales of severity and additional criteria (AC) in order to determine the setting for the treatment of Community-Acquired Pneumonia (CAP).The objective of this study is to correlate the risk regarding three clinical prediction rules (PSI, CURB-65 and PSCRUXO-80) and AC with the effectiveness of hospital at home (HaH).
Evaluation of cases of CAP referred from the Emergency Unit to HaH between January 2000 and May 2008. They were classified regarding three risk scales and presence of AC and its association with the effectiveness of HaH during the treatment was analysed.
146 women and 181 men were admitted, (mean age, 60.3 years). The average stay in HaH was 8.6 days. Two patients died, 25 (7.7%) were admitted to hospital, 219 progressed favourably throughout and 81 after overcoming complications. Hospital at Home was effective in 92.3% of total patients. The rate was 85% for those in PSI=IV or V with or without additional criteria; 80% for CURB-65=2 and 77.5% for a PSCURXO-80 score of 10-19. The effectiveness of HaH is inversely related to severity.
Hospital a Home (HaD) is an effective and safe care option for many cases of CAP in which hospital admission is normally recommended on the basis of prediction rule scores or additional admission criteria.
不同科学协会建议使用严重程度量表和附加标准（AC）来确定社区获得性肺炎（CAP）的治疗环境。本研究的目的是将三种临床预测规则（PSI、CURB - 65和PSCRUXO - 80）及附加标准相关的风险与家庭医院治疗（HaH）的有效性进行关联。
对2000年1月至2008年5月从急诊科转诊至家庭医院治疗的CAP病例进行评估。根据三种风险量表及附加标准的存在情况对病例进行分类，并分析其与家庭医院治疗期间有效性的关联。
共收治146名女性和181名男性患者（平均年龄60.3岁）。在家庭医院的平均住院时间为8.6天。2例患者死亡，25例（7.7%）入院治疗，219例病情顺利进展，81例在克服并发症后康复。家庭医院治疗对92.3%的患者有效。PSI = IV或V级（无论有无附加标准）患者的有效率为85%；CURB - 65 = 2分的患者有效率为80%；PSCURXO - 80评分为10 - 19分的患者有效率为77.5%。家庭医院治疗的有效性与严重程度呈负相关。
对于许多CAP病例，家庭医院治疗（HaD）是一种有效且安全的护理选择，而这些病例通常根据预测规则评分或附加入院标准建议入院治疗。
