Ullah Saleem, Khan Javaid, Khan Amanullah, Hashemy Irfan
Department of Medicine, Karachi Medical & Dental College & Abbasi Shaheed Hospital, Karachi, Pakistan.
Department of Medicine, The Aga Khan University, Karachi, Pakistan.
J Pak Med Assoc. 2017 Mar;67(3):380-385.
To estimate the proportion of community-acquired pneumonia patients with disagreement between Confusion, Uraemia, Respiratory rate, Blood pressure, age > 65 years recommendation and physician's decision to hospitalise or not.
This cross-sectional nation-wide, non-interventional, cross-sectional study was carried out across 10 cities of Pakistan from December 2011 to May 2012, and recruited consenting adult patients with confirmatory diagnosis of community-acquired pneumonia on chest X-ray. Confusion, Uraemia, Respiratory rate, Blood pressure, age > 65 years recommendation for each patient was determined at the time of analysis. This recommendation was compared with treatment decision made by the physician. Disagreement was considered when the physician's decision did not match with the recommendation. SPSS 18 was used for data analysis.
Of the 352 patients, 201(57.10%) were males. The overall mean age was 50.67±18.45 years. In 140(39.77%) patients there was disagreement between Confusion, Uraemia, Respiratory rate, Blood pressure, age > 65 years recommendation and physician's decision regarding hospitalisation or outpatient care. Of the 352 cases 132(37.50%) were hospitalised despite the recommendation of outpatient treatment.
In almost four out of every 10 patients there was disagreement between Confusion, Uraemia, Respiratory rate, Blood pressure, age > 65 years recommendation and the physician's decision regarding hospitalisation of community-acquired pneumonia patients.
评估社区获得性肺炎患者中，在意识模糊、尿毒症、呼吸频率、血压、年龄>65岁的推荐标准与医生关于是否住院的决定之间存在分歧的比例。
这项全国性、非干预性的横断面研究于2011年12月至2012年5月在巴基斯坦的10个城市开展，纳入了经胸部X线确诊为社区获得性肺炎且同意参与研究的成年患者。在分析时确定每位患者的意识模糊、尿毒症、呼吸频率、血压、年龄>65岁的推荐标准。将该推荐标准与医生做出的治疗决定进行比较。当医生的决定与推荐标准不匹配时，视为存在分歧。使用SPSS 18进行数据分析。
352例患者中，201例（57.10%）为男性。总体平均年龄为50.67±18.45岁。140例（39.77%）患者在意识模糊、尿毒症、呼吸频率、血压、年龄>65岁的推荐标准与医生关于住院或门诊治疗的决定之间存在分歧。在352例病例中，132例（37.50%）尽管有门诊治疗的推荐，但仍被收治入院。
在每10例社区获得性肺炎患者中，近4例在意识模糊、尿毒症、呼吸频率、血压、年龄>65岁的推荐标准与医生关于住院的决定之间存在分歧。
