Hospitalization decision for ambulatory patients with community-acquired pneumonia: a prospective study with general practitioners in France.
BACKGROUND
We designed a prospective study in the Puy-de-Dĵme region of France to identify factors associated with a hospitalization decision by general practitioners (GPs) for patients with community-acquired pneumonia (CAP).


METHODS
95 voluntary GPs were recruited to report over the period (February 1993 to March 1994) patients diagnosed with CAP defined as acute onset of fever associated with focal pulmonary crackles and/or radiological changes consistent with a pulmonary infection in patients over 3 years of age, living in the community.


RESULTS
37 of the 175 CAP patients (21.4%) were hospitalized. Univariate analysis showed that the hospitalization decision was related to age > 65 years, retirement, history of cardiovascular disease, other extrapulmonary chronic disease, chest auscultation findings, tachypnea at rest and altered mental status. Multivariate analysis identified four variables associated with hospitalization: living alone at home (OR = 3.75), history of cardiovascular disease (OR = 2.54), other chronic medical conditions excluding pulmonary diseases (OR = 4.28) and tachypnea at rest (OR = 3.33). The hospitalization decision by GPs for patients with CAP takes into account social conditions, co-morbid conditions of the patients and the seventy of CAP.
Laurichesse
H
H
Infectious Diseases Dept., Hôtel-Dieu, University Hospital of Clermont-Ferrand, France. hlaurichesse@chu-clermontferrand.fr
Gerbaud
L
L
Baud
O
O
Gourdon
F
F
Beytout
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000628:therapy; D003657:Decision Making; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010343:Patient Admission / Q000706:statistics & numerical data*; D011014:Pneumonia / Q000628:therapy*; D011446:Prospective Studies