[Are short stay medical units an appropriate place to manage community-acquired pneumonia?].
BACKGROUND
Evaluate patients with community acquired pneumonia (CAP) admitted to our Short Stay Medical Unit (SSMU) in order to establish, using Fines s criteria, whether reducing the length of stay of maximum risk groups (IV and V) is associated with reduction of quality with either an increase of mortality or readmissions. A further objective was to pinpoint the variables associated with a prolongation of hospital stay.


METHODS
All CAP patients admitted to our unit over a eighteen-month period were included in the study. We conducted an univariate analysis and a step wise multivariate analysis of all the variables in the univariate analysis showing a significant statistical relation.


RESULTS
182 patients with a mean age of 73 years were studied. The length of hospital stay was 4.3 days. Stratified by Fine's criteria, 91.2% were included in the groups of maximum risk: 12.1% in group III, 60.4% IV and 18.7% in V. The medium length of stay for each category was 4.3, 4.1 y 5.3 days respectively. The mortality rate was 2.7% and only 5 patients required readmission within one month alter the discharge. Of the variables analyzed only Fine's group V, chronic liver disease and/or renal insufficiency as comorbidities, a pulse rate over 125 per minute and blood glucose level > 250 mg/l showed a significant relation with more than five days hospitalization, and out of them, only the three latter stayed in the multivariate analysis.


CONCLUSIONS
All CAP patients, including those in Fine's groups IV and V, can be treated safely and efficiently in a SSMU, providing there is an outpatient clinic for immediate consultation available.
Noval Menéndez
J
J
Servicio de Medicina Interna, Hospital de Cabueñes, C/Los Prados 395, 33203 Gijón. julio.noval@sespa.princast.es
Campoamor Serrano
M T
MT
Avanzas González
E
E
Galiana Martín
D
D
Morís de la Tassa
J
J
D000368:Aged; D000553:Ambulatory Care; D017714:Community-Acquired Infections / Q000401:mortality / Q000628:therapy; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D011014:Pneumonia / Q000401:mortality / Q000628:therapy*; D013030:Spain