title: Elderly patients with community-acquired pneumonia are not treated according to current guidelines.
abstract: BACKGROUND
  Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality in elderly patients, and the most important cause of death in the developed world. Optimised treatment and care will benefit patients as well as the health economy. This study investigated in-hospital compliance with guidelines for treatment and care of patients with CAP.
  
  
  METHODS
  A retrospective nationwide study examining 100 patient records from 20 Danish hospitals regarding patients 65 years and older admitted for CAP.
  
  
  RESULTS
  A total of 74 patients with a mean age 81.6 years were included. The mean length of stay was 9.2 days, 30- and 90-day mortality rates were 12.2 and 17.6% and readmission rates 4% (seven days) and 9.5% (30 days). Severity assessment was made in two cases. Observations of vital parameters were unsystematic and the respiratory rate was measured only in six cases. Diagnostic tests and treatment initiation were mostly in accordance with guidelines. The mean number of days on intravenous antibiotics was 5.5. Nutrition and mobilisation were neglected or only sporadically addressed. No systematic plan for treatment and care was found.
  
  
  CONCLUSIONS
  While medical treatment mainly concurred with guidelines, a potential for reduced costs by early discharge planning and use of systematic assessment tools for site-of-care and treatment decisions was indicated. The lack of systematic interventions in the prevention and treatment of malnutrition and functional decline constitutes a threat to a successful final patient outcome.
  
  
  BACKGROUND
  The Danish Ministry of Health funded the study.
  
  
  BACKGROUND
  The Danish Data Register approved the project (J. No. 2010-41-5358).
authors: Høje Lønholt 9, 3480 Fredensborg, Denmark. tove.lindhardt@gmail.com
authors: Tove
authors: T
authors: Lindhardt
authors: Henrik Hedegaard
authors: HH
authors: Klausen
authors: Christina
authors: C
authors: Christiansen
authors: Louise Lawson
authors: LL
authors: Smith
authors: Janne
authors: J
authors: Pedersen
authors: Ove
authors: O
authors: Andersen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000534:rehabilitation / Q000628:therapy; D003718:Denmark; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007902:Length of Stay; D008297:Male; D008485:Medical Audit; D015596:Nutrition Assessment; D018529:Nutritional Support; D010347:Patient Care Planning; D010359:Patient Readmission; D011014:Pneumonia / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D017410:Practice Guidelines as Topic; D017064:Process Assessment, Health Care; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents