Hospitalización diurna como modelo de atención de salud en pacientes adultos inmunocompetentes con neumonía adquirida en la comunidad / Respiratory day hospital care for immunocompetent adult patients with community-acquired pneumonia
Rev. méd. Chile
; 143(4): 467-474, abr. 2015. tab
Artigo
em Espanhol
| LILACS
| ID: lil-747553
Biblioteca responsável:
CL1.1
ABSTRACT
Background:
Day hospitals can reduce health care costs without increasing the risks of patients with lower respiratory tract infection.Aim:
To report the experience of a respiratory day hospital care delivered to adult patients with community-acquired pneumonia (CAP) in a public hospital. Material andMethods:
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.
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Contexto em Saúde:
ODS3 - Meta 3.8 Atingir a cobertura universal de saúde
/
ODS3 - Meta 3.3 Acabar com as doenças tropicais negligenciadas e combater as doenças transmissíveis
/
ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis
Problema de saúde:
Arranjos de Entrega
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Pneumonía
/
Asma
/
Doença Pulmonar Obstrutiva Crônica (DPOC)
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Outras Doenças Respiratórias
Base de dados:
LILACS
Assunto principal:
Pneumonia
/
Atenção Primária à Saúde
/
Hospedeiro Imunocomprometido
/
Doença Pulmonar Obstrutiva Crônica
/
Hospital Dia
Tipo de estudo:
Estudo de etiologia
/
Guia de prática clínica
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Adolescente
/
Adulto
/
Idoso
/
Idoso, 80 anos ou mais
/
Feminino
/
Humanos
/
Masculino
Idioma:
Espanhol
Revista:
Rev. méd. Chile
Assunto da revista:
Medicina
Ano de publicação:
2015
Tipo de documento:
Artigo
País de afiliação:
Chile
Instituição/País de afiliação:
Servicio de Salud Metropolitano Norte/CL