Patients with community acquired pneumonia discharged from the emergency department according to a clinical practice guideline.
OBJECTIVE
To assess the safety of discharging patients with community acquired pneumonia (CAP) according to a clinical practice guideline.


METHODS
A systematic retrospective review of medical records of 867 adult patients discharged from an emergency department (ED) with CAP between 3 January 1999 and 3 January 2001. Readmission or death rates within 30 days of discharge were evaluated, using data from all local hospitals and from the provincial coroner.


RESULTS
Of 685 patients with pneumonia severity index (PSI) scores of <91, 13 (1.9%) were readmitted and five (0.76%) died within 30 days of the ED visit. Thirty day readmission and death rates for patients with PSI >90 were 7.14% (13 of 182) and 9.34% (17 of 182), respectively.


CONCLUSIONS
Adult patients with CAP discharged from the ED according to the recommendations of a clinical practice guideline based on the PSI have low readmission and death rates, and are generally safely managed as outpatients.
Campbell
S G
SG
Department of Emergency Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. samuel.campbell@cdha.nshealth.ca <samuel.campbell@cdha.nshealth.ca>
Patrick
W
W
Urquhart
D G
DG
Maxwell
D M
DM
Ackroyd-Stolarz
S A
SA
Murray
D D
DD
Hawass
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000401:mortality / Q000628:therapy; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit / Q000379:methods; D008875:Middle Aged; D010351:Patient Discharge; D010359:Patient Readmission; D011014:Pneumonia / Q000401:mortality / Q000628:therapy*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012449:Safety; D012720:Severity of Illness Index