Giuseppe
Emeritus
[Source: BioMed Central, full text: (LINK). Abstract, edited.]
A Clinical Pathway for Community-Acquired Pneumonia: An Observational Cohort Study
Christopher R Frei, Allison M Bell, Kristi A Traugott, Terry C Jaso, Kelly R Daniels, Eric M Mortensen, Marcos I Restrepo, Christine U Oramasionwu, Andres D Ruiz, William R Mylchreest, Vanja Sikirica, Monika R Raut, Alan Fisher and Jeff R Schein
BMC Infectious Diseases 2011, 11:188doi:10.1186/1471-2334-11-188
Published: 6 July 2011
Abstract (provisional)
Background
Six hospitals instituted a voluntary, system-wide, pathway for community acquired pneumonia (CAP). We proposed this study to determine the impact of pathway antibiotics on patient survival, hospital length of stay (LOS), and total hospital cost.
Methods
Data were collected for adults from six U.S. hospitals with a principal CAP discharge diagnosis code, a chest infiltrate, and medical notes indicative of CAP from 2005-2007. Pathway and non-pathway cohorts were assigned according to antibiotics received within 48 hours of admission. Pathway antibiotics included levofloxacin 750mg monotherapy or ceftriaxone 1000mg plus azithromycin 500mg daily. Multivariable regression models assessed 90-day mortality, hospital LOS, total hospital cost, and total pharmacy cost.
Results
Overall, 792 patients met study criteria. Of these, 505 (64%) received pathway antibiotics and 287 (36%) received non-pathway antibiotics. Adjusted means and p-values were derived from Least Squares regression models that included Pneumonia Severity Index risk class, patient age, heart failure, chronic obstructive pulmonary disease, and admitting hospital as covariates. After adjustment, patients who received pathway antibiotics experienced lower adjusted 90-day mortality (p=0.02), shorter mean hospital LOS (3.9 vs. 5.0 days, p<0.01), lower mean hospital costs ($2,485 vs. $3,281, p=0.02), and similar mean pharmacy costs ($356 vs. $442, p=0.11).
Conclusions
Pathway antibiotics were associated with improved patient survival, hospital LOS, and total hospital cost for patients admitted to the hospital with CAP.
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A Clinical Pathway for Community-Acquired Pneumonia: An Observational Cohort Study
Christopher R Frei, Allison M Bell, Kristi A Traugott, Terry C Jaso, Kelly R Daniels, Eric M Mortensen, Marcos I Restrepo, Christine U Oramasionwu, Andres D Ruiz, William R Mylchreest, Vanja Sikirica, Monika R Raut, Alan Fisher and Jeff R Schein
BMC Infectious Diseases 2011, 11:188doi:10.1186/1471-2334-11-188
Published: 6 July 2011
Abstract (provisional)
Background
Six hospitals instituted a voluntary, system-wide, pathway for community acquired pneumonia (CAP). We proposed this study to determine the impact of pathway antibiotics on patient survival, hospital length of stay (LOS), and total hospital cost.
Methods
Data were collected for adults from six U.S. hospitals with a principal CAP discharge diagnosis code, a chest infiltrate, and medical notes indicative of CAP from 2005-2007. Pathway and non-pathway cohorts were assigned according to antibiotics received within 48 hours of admission. Pathway antibiotics included levofloxacin 750mg monotherapy or ceftriaxone 1000mg plus azithromycin 500mg daily. Multivariable regression models assessed 90-day mortality, hospital LOS, total hospital cost, and total pharmacy cost.
Results
Overall, 792 patients met study criteria. Of these, 505 (64%) received pathway antibiotics and 287 (36%) received non-pathway antibiotics. Adjusted means and p-values were derived from Least Squares regression models that included Pneumonia Severity Index risk class, patient age, heart failure, chronic obstructive pulmonary disease, and admitting hospital as covariates. After adjustment, patients who received pathway antibiotics experienced lower adjusted 90-day mortality (p=0.02), shorter mean hospital LOS (3.9 vs. 5.0 days, p<0.01), lower mean hospital costs ($2,485 vs. $3,281, p=0.02), and similar mean pharmacy costs ($356 vs. $442, p=0.11).
Conclusions
Pathway antibiotics were associated with improved patient survival, hospital LOS, and total hospital cost for patients admitted to the hospital with CAP.
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