title: [Respiratory day hospital care for immunocompetent adult patients with community-acquired pneumonia].
abstract: BACKGROUND
  Day hospitals can reduce health care costs without increasing the risks of patients with lower respiratory tract infection.
  
  
  OBJECTIVE
  To report the experience of a respiratory day hospital care delivered to adult patients with community-acquired pneumonia (CAP) in a public hospital.
  
  
  METHODS
  During the fall and winter of 2011 and 2012, adult patients with CAP of intermediate risk categories were assessed in the emergency room, their severity was stratified according to confusion, respiratory rate, blood pressure, 65 years of age or older (CRB-65) score and the Chilean CAP Clinical Guidelines, and were admitted to the respiratory day hospital.
  
  
  RESULTS
  One hundred seventeen patients aged 67 ± 16 years, (62% females) with CAP were attended in the respiratory day hospital. Ninety percent had comorbidities, especially chronic obstructive pulmonary disease in 58%, heart disease in 32%, diabetes in 16% and asthma in 13%. Their most important risk factors were age over 65 years in 60%, comorbidities in 88%, failure of antibiotic treatment in 17%, loss of autonomy in 21%, vital sign abnormalities in 60%, mental confusion in 5%, multilobar CAP in 23%, pleural effusion in 15%, hypoxemia in 41% and a serum urea nitrogen over 30 mg/dL in 16%. Patients stayed an average of seven days in the day hospital with oxygen, hydration, chest physiotherapy and third-generation cephalosporins (89%) associated with quinolones (52%) or macrolides (4%). Thirteen patients required noninvasive ventilation, eight patients were hospitalized because of clinical deterioration and three died in hospital.
  
  
  CONCLUSIONS
  Day hospital care reduced hospital admission rates of patients with lower respiratory tract infections.
authors.forename: Rosa  T
authors.initials: R
authors.lastname: Roldán
authors.forename: María Elena P
authors.initials: ME
authors.lastname: Torres
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Gallardo
authors.forename: Marisol C
authors.initials: MC
authors.lastname: Arias
authors.forename: Fernando P
authors.initials: FP
authors.lastname: Saldías
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology; D017714:Community-Acquired Infections / Q000276:immunology / Q000401:mortality / Q000628:therapy; D015897:Comorbidity; D003631:Day Care, Medical; D005260:Female; D006331:Heart Diseases / Q000401:mortality / Q000628:therapy; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D063087:Noninvasive Ventilation; D011014:Pneumonia / Q000276:immunology / Q000401:mortality* / Q000628:therapy; D011320:Primary Health Care; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality* / Q000628:therapy; D056152:Respiratory Rate / Q000502:physiology; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents