Please use this identifier to cite or link to this item: http://hdl.handle.net/10553/46584
Title: Initial management of pneumonia and sepsis: Factors associated with improved outcome
Authors: Menéndez, R.
Torres, A.
Reyes, S.
Zalacain, R.
Capelastegui, A.
Aspa, J.
Borderías, L.
Martín-Villasclaras, J. J.
Bello, S.
Alfageme, I.
De Castro, F. R. 
Rello, J.
Molinos, L.
Ruiz-Manzano, J.
UNESCO Clasification: 32 Ciencias médicas
320508 Enfermedades pulmonares
Keywords: Audit
Community-acquired pneumonia
Compliance
Length of stay
Mortality, et al
Issue Date: 2011
Journal: European Respiratory Journal 
Abstract: Processes of care and adherence to guidelines have been associated with improved survival in community-acquired pneumonia (CAP). In sepsis, bundles of processes of care have also increased survival. We aimed to audit compliance with guideline-recommended processes of care and its impact on outcome in hospitalised CAP patients with sepsis. We prospectively studied 4,137 patients hospitalised with CAP in 13 hospitals. The processes of care evaluated were adherence to antibiotic prescription guidelines, first dose within 6 h and oxygen assessment. Outcome measures were mortality and length of stay (LOS). Oxygen assessment was measured in 3,745 (90.5%) patients; 3,024 (73.1%) patients received antibiotics according to guidelines and 3,053 (73.8%) received antibiotics within 6 h. In CAP patients with sepsis, the strongest independent factor for survival was antibiotic adherence (OR 0.4). In severe sepsis, only compliance to antibiotic adherence plus first dose within 6 h was associated with lower mortality (OR 0.60), adjusted for fine prognostic scale and hospital. Antibiotic adherence was related to shorter hospital stay. In sepsis, antibiotic adherence is the strongest protective factor of care associated with survival and LOS. In severe sepsis, combined antibiotic adherence and first dose within 6 h may reduce mortality.
URI: http://hdl.handle.net/10553/46584
ISSN: 0903-1936
DOI: 10.1183/09031936.00188710
Source: European Respiratory Journal [ISSN 0903-1936],v. 39, p. 156-162
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