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Emerg Med J 2004;21:667-669 doi:10.1136/emj.2003.011833
  • Original Article

Patients with community acquired pneumonia discharged from the emergency department according to a clinical practice guideline

  1. S G Campbell1,
  2. W Patrick2,
  3. D G Urquhart1,
  4. D M Maxwell1,
  5. S A Ackroyd-Stolarz1,
  6. D D Murray1,
  7. A Hawass1
  1. 1Department of Emergency Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
  2. 2Department of Medicine, Dalhousie University
  1. Correspondence to:
 Dr S G Campbell
 Department of Emergency Medicine, QEII Health Sciences Centre, 1796 Summer Street, HI 3021, Halifax, Nova Scotia, Canada B3H 3A7; samuel.campbellcdha.nshealth.ca
  • Accepted 2 February 2004

Abstract

Objectives: To assess the safety of discharging patients with community acquired pneumonia (CAP) according to a clinical practice guideline.

Methods: A systematic retrospective review of medical records of 867 adult patients discharged from an emergency department (ED) with CAP between 3 January 1999 and 3 January 2001. Readmission or death rates within 30 days of discharge were evaluated, using data from all local hospitals and from the provincial coroner.

Results: Of 685 patients with pneumonia severity index (PSI) scores of <91, 13 (1.9%) were readmitted and five (0.76%) died within 30 days of the ED visit. Thirty day readmission and death rates for patients with PSI >90 were 7.14% (13 of 182) and 9.34% (17 of 182), respectively.

Conclusion: Adult patients with CAP discharged from the ED according to the recommendations of a clinical practice guideline based on the PSI have low readmission and death rates, and are generally safely managed as outpatients.

Footnotes

  • Funding: none.

  • Conflicts of interest: none declared.

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