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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Variability in the management of patients hospitalized with community-acquired pneumonia &#40;CAP&#41; is attributable to many factors&#46; The objective of this study was to determine whether such variability is influenced by the medical specialty area where the patient is treated&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">The treatment and outcomes for a random sample of patients with CAP admitted to 4 hospitals over 2 periods &#40;1 year starting March 1&#44; 1998&#44; and 1&#46;5 years starting March 1&#44; 2000&#41; were compared by medical specialty department&#46; Multiple linear and logistic regression models were used to analyze differences&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Differences were found between departments in the coverage of atypical pathogens &#40;<span class="elsevierStyleItalic">P</span> &#60;&#46;001&#41;&#46; The adjusted mean length of stay in hospital varied between 6&#46;8 and 9&#46;1 days &#40;<span class="elsevierStyleItalic">P</span> &#60;&#46;01&#41;&#44; and the duration of intravenous treatment varied between 4&#46;6 and 7&#46;3 days &#40;<span class="elsevierStyleItalic">P</span> &#60;&#46;05&#41;&#46; Adjusted models showed that mortality in hospital and at 30 days was significantly higher for patients treated in internal medicine departments &#40;odds ratios&#58; 2&#46;1 and 2&#44; respectively&#41; than for those treated in pulmonology departments&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Interdepartmental differences were observed in how patients hospitalized with CAP were treated and in the outcomes achieved&#46; This variation is probably influenced by the differences that were found in the use of antibiotics&#46;</p>"
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Vol. 41. Issue 6.
Pages 300-306 (June 2005)
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Vol. 41. Issue 6.
Pages 300-306 (June 2005)
Original Articles
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Patients Hospitalized With Community-Acquired Pneumonia: a Comparative Study of Outcomes by Medical Specialty Area
Visits
4341
A. Capelasteguia,
Corresponding author
acapelas@hgda.osakidetza.net

Correspondence: Dr. A. Capelastegui. Servicio de Neumología. Hospital de Galdakao. B. Labeaga, s/n. 48960 Galdakao. Bizkaia. España
, P.P. Españaa, J.M. Quintanab, I. Gorordoa, A. Martínez Urquiric, I. Idoiagad, A. Bilbaob
a Servicio de Neumología, Hospital de Galdakao, Galdakao, Bizkaia, Spain
b Unidad de Investigación, Hospital de Galdakao, Galdakao, Bizkaia, Spain
c Servicio de Urgencias, Hospital de Galdakao, Galdakao, Bizkaia, Spain
d Medicina de Familia, Hospital de Galdakao, Galdakao, Bizkaia, Spain
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Article information
Objective

Variability in the management of patients hospitalized with community-acquired pneumonia (CAP) is attributable to many factors. The objective of this study was to determine whether such variability is influenced by the medical specialty area where the patient is treated.

Patients and methods

The treatment and outcomes for a random sample of patients with CAP admitted to 4 hospitals over 2 periods (1 year starting March 1, 1998, and 1.5 years starting March 1, 2000) were compared by medical specialty department. Multiple linear and logistic regression models were used to analyze differences.

Results

Differences were found between departments in the coverage of atypical pathogens (P <.001). The adjusted mean length of stay in hospital varied between 6.8 and 9.1 days (P <.01), and the duration of intravenous treatment varied between 4.6 and 7.3 days (P <.05). Adjusted models showed that mortality in hospital and at 30 days was significantly higher for patients treated in internal medicine departments (odds ratios: 2.1 and 2, respectively) than for those treated in pulmonology departments.

Conclusions

Interdepartmental differences were observed in how patients hospitalized with CAP were treated and in the outcomes achieved. This variation is probably influenced by the differences that were found in the use of antibiotics.

Key words:
Community-acquired pneumonia
Variability
Treatment
Results
Objetivo

La variabilidad en el manejo de los pacientes ingresados por una neumonía adquirida en la comunidad (NAC) es multifactorial. Nuestro objetivo fue comprobar si en ello influye la especialidad del servicio responsable.

Pacientes y métodos

Se compararon entre servicios el tratamiento y los resultados de una muestra aleatoria de los pacientes ingresados por NAC en 4 hospitales durante 2 perío-dos (un año desde el 1 de marzo de 1998; un año y medio des-de el 1 de marzo de 2000). Se emplearon modelos de regresión lineal múltiple y logística para ajustar las diferencias.

Resultados

Se encontraron diferencias entre servicios en la cobertura de gérmenes atípicos (p < 0,001). La duración media ajustada de la estancia hospitalaria osciló entre 6,8 y 9,1 días (p < 0,01) y la del tratamiento intravenoso entre 4,6 y 7,3 días (p < 0,05). Los análisis ajustados demostraron que la mortalidad intrahospitalaria y a los 30 días fue significativa-mente superior en los servicios de medicina interna (odds ratio: 2,1 y 2, respectivamente) respecto a los de neumología.

Conclusiones

Se observaron diferencias entre servicios en el tratamiento de los pacientes ingresados por NAC y en sus resultados. Es probable que en ello influyan las diferencias encontradas en la utilización de los antibióticos.

Palabras clave:
Neumonía adquirida en la comunidad
Variabilidad
Tratamiento
Resultados
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Copyright © 2005. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
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