Stratification Process in Hospitalized Patients with Community-Acquired Pneumonia
Abstract
Introduction: An instrument has been used for stratifying patients with community-acquired pneumonia in the emergency department since 2006.Objective: To evaluate the stratifying process of patients with community-acquired pneumonia in hospitalized patients.Methods: A descriptive study that included 1 809 patients hospitalized in the emergency department from 2009 to 2019 was carried out. A control stratification evaluated the process, which allowed determining the frequency and quality of the initial stratification, as well as the coincidence between this and the actual stratification. In the statistical analysis, the ratio of crossed products (Odds Ratio) and X2 statistic were used for differences in proportions; a significance level of 95% was accepted.Results: The stratification index of the series was 86%, and the adequate stratification index was 80%. Patients with moderate pneumonia and high probabilities of unfavorable evolution predominated. The lowest stratification was found in patients with severe pneumonia and high probability of recovery (p <.05). There were differences in the quality of stratification between the groupings of strata IA-IB-IIA and IIB-IIIA-IIIB (p <.05); these last three strata sowed the highest figures of the positive predictive value of the initial stratification (p <.05).Conclusions: The stratification process of hospitalized community-acquired pneumonia patients was characterized by high stratification frequency and adequate quality. However, this study identified groups of patients and specific situations that were considered as "areas of improvement", important for improving the quality of care.
Keywords: pneumonia; community acquired infections; emergency medical services.
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