Trial reportJournal of general internal medicine2006
Factors associated with the hospitalization of low-risk patients with community-acquired pneumonia in a cluster-randomized trial.
Trial report in Journal of general internal medicine, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America.American journal of respiratory and critical care medicine · 2019Guideline
- Guidelines for the management of adult lower respiratory tract infections--full version.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2011Guideline
- Biomarker-enhanced triage in respiratory infections: a proof-of-concept feasibility trial.The European respiratory journal · 2013Trial
- Trial
- Which patients with lower respiratory tract infections need inpatient treatment? Perceptions of physicians, nurses, patients and relatives.BMC pulmonary medicine · 2010Trial
- Ten Issues for Updating in Community-Acquired Pneumonia: An Expert Review.Journal of clinical medicine · 2023Review
- 52-year follow-up of a birth cohort reveals a high pneumonia incidence among young men.ERJ open research · 2022Article
- Article
- Community-acquired pneumonia: similarities and differences between European and American guidelines - A narrative review.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2021Review
- Development and Implementation of a Clinical Pathway to Reduce Inappropriate Admissions Among Patients with Community-Acquired Pneumonia in a Private Health System in Brazil: An Observational Cohort Study and a Promising Tool for Efficiency Improvement.Open access emergency medicine : OAEM · 2020Article
- Guideline for Antibiotic Use in Adults with Community-acquired Pneumonia.Infection & chemotherapy · 2018Review
- Article
- Effectiveness of Proadrenomedullin Enhanced CURB65 Score Algorithm in Patients with Community-Acquired Pneumonia in "Real Life", an Observational Quality Control Survey.Journal of clinical medicine · 2014Article
- The potential impact of biomarker-guided triage decisions for patients with urinary tract infections.Infection · 2013Article
- Impact of admission blood glucose level on outcomes in community-acquired pneumonia in older adults.International journal of general medicine · 2013Article
- Predictors for length of hospital stay in patients with community-acquired pneumonia: results from a Swiss multicenter study.BMC pulmonary medicine · 2012Article
- The value of prognostic indices for pneumonia.Current infectious disease reports · 2008Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundMany low-risk patients with pneumonia are hospitalized despite recommendations to treat such patients in the outpatient setting.
objectiveTo identify the factors associated with the hospitalization of low-risk patients with pneumonia.
methodsWe analyzed data collected by retrospective chart review for 1,889 low-risk patients (Pneumonia Severity Index [PSI] risk classes I to III without evidence of arterial oxygen desaturation) enrolled in a cluster-randomized trial conducted in 32 emergency departments.
resultsOverall, 845 (44.7%) of all low-risk patients were treated as inpatients. Factors independently associated with an increased odds of hospitalization included PSI risk classes II and III, the presence of medical or psychosocial contraindications to outpatient treatment, comorbid conditions that were not contained in the PSI (cognitive impairment, history of coronary artery disease, diabetes mellitus, or pulmonary disease), multilobar radiographic infiltrates, and home therapy with oxygen, corticosteroids, or antibiotics before presentation. While 32.8% of low-risk inpatients had a contraindication to outpatient treatment and 47.1% had one or more preexisting treatments, comorbid conditions, or radiographic abnormalities not contained in the PSI, 20.1% had no identifiable risk factors for hospitalization other than PSI risk class II or III.
conclusionsHospital admission appears justified for one-third of low-risk inpatients based upon the presence of one or more contraindications to outpatient treatment. At least one-fifth of low-risk inpatients did not have a contraindication to outpatient treatment or an identifiable risk factor for hospitalization, suggesting that treatment of a larger proportion of such low-risk patients in the outpatient setting could be achieved without adversely affecting patient outcomes.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.