RT Journal Article
T1 Compliance with guidelines-recommended processes in pneumonia: impact of health status and initial signs
A1 Menéndez, Rosario
A1 Torres, Antoni
A1 Reyes, Soledad
A1 Zalacain, Rafael
A1 Capelastegui, Alberto
A1 Rajas, Olga
A1 Borderías, Luis
A1 Martín-Villasclaras, Juan J.
A1 Bello, Salvador
A1 Alfageme, Inmaculada
A1 Rodríguez de Castro, Felipe
A1 Rello, Jordi
A1 Molinos, Luis
A1 Ruiz-Manzano, Juan
K1 Antibacterianos
K1 Adhesión a Directriz
K1 Estado de Salud
K1 Hospitales
K1 Neumonía
K1 Guías de Práctica Clínica como Asunto
K1 Estudios Prospectivos
K1 Resultado del Tratamiento
K1 España
AB Initial care has been associated with improved survival of community-acquired pneumonia (CAP). We aimed to investigate patient comorbidities and health status measured by the Charlson index and clinical signs at diagnosis associated with adherence to recommended processes of care in CAP. We studied 3844 patients hospitalized with CAP. The evaluated recommendations were antibiotic adherence to Spanish guidelines, first antibiotic dose <6 hours and oxygen assessment. Antibiotic adherence was 72.6%, first dose <6 h was 73.4% and oxygen assessment was 90.2%. Antibiotic adherence was negatively associated with a high Charlson score (Odds ratio [OR], 0.91), confusion (OR, 0.66) and tachycardia ≥100 bpm (OR, 0.77). Delayed first dose was significantly lower in those with tachycardia (OR, 0.75). Initial oxygen assessment was negatively associated with fever (OR, 0.61), whereas tachypnea ≥30 (OR, 1.58), tachycardia (OR, 1.39), age >65 (OR, 1.51) and COPD (OR, 1.80) were protective factors. The combination of antibiotic adherence and timing <6 hours was negatively associated with confusion (OR, 0.69) and a high Charlson score (OR, 0.92) adjusting for severity and hospital effect, whereas age was not an independent factor. Deficient health status and confusion, rather than age, are associated with lower compliance with antibiotic therapy recommendations and timing, thus identifying a subpopulation more prone to receiving lower quality care.
PB Public Library of Science
YR 2012
FD 2012-05-22
LK http://hdl.handle.net/10668/849
UL http://hdl.handle.net/10668/849
LA en
NO Menéndez R, Torres A, Reyes S, Zalacain R, Capelastegui A, Rajas O, et al. Compliance with guidelines-recommended processes in pneumonia: impact of health status and initial signs. PLoS ONE. 2012; 7(5):e37570
NO Journal Article; Research Support, Non-U.S. Gov't;
DS RISalud
RD Apr 8, 2025