[Efficacy of hospital at home (HaH) in the treatment of community-acquired pneumonia (CAP) with different degrees of severity].
OBJECTIVE
Different scientific societies propose the use of scales of severity and additional criteria (AC) in order to determine the setting for the treatment of Community-Acquired Pneumonia (CAP).The objective of this study is to correlate the risk regarding three clinical prediction rules (PSI, CURB-65 and PSCRUXO-80) and AC with the effectiveness of hospital at home (HaH).


METHODS
Evaluation of cases of CAP referred from the Emergency Unit to HaH between January 2000 and May 2008. They were classified regarding three risk scales and presence of AC and its association with the effectiveness of HaH during the treatment was analysed.


RESULTS
146 women and 181 men were admitted, (mean age, 60.3 years). The average stay in HaH was 8.6 days. Two patients died, 25 (7.7%) were admitted to hospital, 219 progressed favourably throughout and 81 after overcoming complications. Hospital at Home was effective in 92.3% of total patients. The rate was 85% for those in PSI=IV or V with or without additional criteria; 80% for CURB-65=2 and 77.5% for a PSCURXO-80 score of 10-19. The effectiveness of HaH is inversely related to severity.


CONCLUSIONS
Hospital a Home (HaD) is an effective and safe care option for many cases of CAP in which hospital admission is normally recommended on the basis of prediction rule scores or additional admission criteria.
Regalado de Los Cobos
José
J
Unidad de Hospitalización a Domicilio de Vitoria-Gasteiz, Hospital Txagorritxu y Hospital Santiago Apóstol, Vitoria-Gasteiz, España. jose.regaladodeloscobos@osakidetza.net
Aizpuru Barandiaran
Felipe
F
Oceja Barrutieta
Esther
E
de Juan Rodríguez
María
M
Apraiz Ruiz
Leire
L
Altuna Basurto
Elena
E
Gomez Rodríguez de Mendarozqueta
Montserrat
M
López-Picado
Amanda
A
Cia Ruiz
Juan Miguel
JM
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000401:mortality / Q000451:nursing / Q000628:therapy*; D005260:Female; D018575:Home Care Services, Hospital-Based / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D010359:Patient Readmission / Q000706:statistics & numerical data; D011014:Pneumonia / Q000188:drug therapy / Q000401:mortality / Q000451:nursing / Q000628:therapy*; D015397:Program Evaluation; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013030:Spain
D000900:Anti-Bacterial Agents