title: [Community-acquired pneumonia: from national recommendations to regional standards].
abstract: Community-acquired pneumonia (CAP) is a major challenge facing health service. The aim of this work was to estimate the effectiveness of introduction of Sverdlovsk region territorial CAP standards into clinical practice in 2002-2011.
  
  
  METHODS
  Retrospective analysis included 523 case histories of the patients who diedfrom CAP and 127 one who recovered after treatment (groups 1 and 2 respectively). The primary end-point was general and intrahospital mortality rate, secondary end-points the day of admission to the intensive therapy unit (ITI) and the onset of starting antibiotic therapy (ABT), conformity of ABT to the regional standard. Independent and patient/hospital-dependent risk factors of unfavourable outcome of CAP were subjected to statistical analysis.
  
  
  RESULTS
  In 2002-2011 mortality rate among the able-bodied population and hospitalized patients with CAP decreased by 46 and 15.4% respectively (overall 30.7%). Chronic alcoholism, poor social status (to 53.9 +/- 2.4%), late application for medical aid (77% of the patients applied later than 3 days after the onset of CAP) were risk factors of unfavourable outcome. The time of CAP onset in groups 1 an d 2 was 5.7 +/- 10.3 and 2.2 +/- 4.5 hr respectively (OR: 5.31 [95% CI 2.32 = 12.16] p < 0.01). ABT conformed with the regional standards in 7.4 and 92.1% of the cases in groups I and 2.
  
  
  CONCLUSIONS
  Strict compliance with national guidelines and regional programs ensures success of diagnostics and treatment of CAR
authors: I V
authors: IV
authors: Leshchenko
authors: Z D
authors: ZD
authors: Bobyleva
authors: N M
authors: NM
authors: Trifanova
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D015897:Comorbidity; D005260:Female; D006287:Health Planning Guidelines; D006301:Health Services Needs and Demand; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D012040:Regional Health Planning; D012307:Risk Factors; D012426:Russia / Q000453:epidemiology; D012959:Socioeconomic Factors; D061665:Time-to-Treatment
chemical_list: D000900:Anti-Bacterial Agents