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[短期住院单元作为75岁以上人群社区获得性肺炎治疗中传统住院治疗的替代方案]

[The short stay unit as an alternative to conventional hospitalisation in the treatment of community acquired pneumonia in the over 75 year-old population].

作者信息

Juan Pastor Antoni, Ferré Losa Carles, Llopis Roca Ferran, Jacob Rodríguez Javier, Bardés Robles Ignasi, Salazar Soler Albert

机构信息

Unidad de Corta Estancia, Servicio de Urgencias, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.

出版信息

Rev Esp Geriatr Gerontol. 2011 Jul-Aug;46(4):213-6. doi: 10.1016/j.regg.2011.02.008. Epub 2011 Jun 29.

Abstract

INTRODUCTION

Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality in elderly patients. The short stay units can be an alternative for patients who need admission with acute illness.

MATERIAL AND METHODS

Descriptive and retrospective study in an Short-Stay Unit (SSU) of a 900-bed tertiary-care teaching hospital in the metropolitan area of Barcelona, Spain.

PERIOD

a total of 22 months from January 2004 to December 2006.

PATIENTS

all patients ≥ 75 years admitted to EDSSU with a diagnosis of CAP. Data were collected for demographic variables, Pneumonia Severity Index score (PSI), microbiological findings, antibiotic treatment, length of stay, mortality rates and new admissions during the 30 days following discharge.

RESULTS

175 consecutive patients ≥ 75 years with pneumonia were admitted to the EDSSU. Mean age was 84.31 years (range 75-100, SD ± 5.76), 92 (52,5%) were men, with 24 being nursing home residents. According to the PSI, 64 cases (36.6%) were scored as III, 97 (55.4%) as IV and 14 (8%) as V. A positive microbiological result was obtained in 46 cases (26.2%). Length of stay on average was 3.29 days (range 1-10, SD ± 1.56) and 19 patients died (10.8%). Six (3.8%) attended the ED in the 30 days following discharge.

CONCLUSIONS

In view of our experience, the EDSSU can be an alternative to standard inpatient for elderly patients with pneumonia in PSI risk class III and IV.

摘要

引言

社区获得性肺炎(CAP)是老年患者发病和死亡的主要原因。短期住院单元可以作为需要因急性疾病入院治疗患者的一种选择。

材料与方法

在西班牙巴塞罗那大都市区一家拥有900张床位的三级护理教学医院的短期住院单元(SSU)进行描述性和回顾性研究。

时间段

2004年1月至 2006年12月,共22个月。

患者

所有年龄≥75岁、因CAP诊断入住急诊短期住院单元(EDSSU)的患者。收集了人口统计学变量、肺炎严重程度指数评分(PSI)、微生物学检查结果、抗生素治疗、住院时间、死亡率以及出院后30天内再次入院情况的数据。

结果

175例年龄≥75岁的肺炎患者连续入住EDSSU。平均年龄为84.31岁(范围75 - 100岁,标准差±5.76),92例(52.5%)为男性,其中24例为养老院居民。根据PSI评分,64例(36.6%)为III级,97例(55.4%)为IV级,14例(8%)为V级。46例(26.2%)微生物学检查结果呈阳性。平均住院时间为3.29天(范围1 - 10天,标准差±1.56),19例患者死亡(10.8%)。6例(3.8%)患者在出院后30天内再次就诊于急诊。

结论

鉴于我们的经验,对于PSI风险分级为III级和IV级的老年肺炎患者,急诊短期住院单元可以作为标准住院治疗的一种替代选择。

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