RT Journal Article
SR Electronic
T1 Does early review by a respiratory physician lead to a shorter length of stay for patients with non-severe community-acquired pneumonia?
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 709
OP 712
DO 10.1136/thx.2008.109983
VO 64
IS 8
A1 T Bewick
A1 V J Cooper
A1 W S Lim
YR 2009
UL http://thorax.bmj.com/content/64/8/709.abstract
AB Background: The aim of this study was to evaluate whether patients with non-severe community-acquired pneumonia (CAP) have a shorter length of stay (LOS) when initially seen by a respiratory physician compared with a non-respiratory physician.Methods: At Nottingham City Hospital, following nurse triage, acute medical patients who are not severely ill are admitted to the consultant-led emergency short stay unit (ESSU). Records of patients seen on ESSU between January 2004 and December 2007 with a clinical discharge code relating to CAP were retrospectively examined. Patients with a diagnosis of cellulitis over the same time period were used as controls. Patients were grouped depending on whether they were seen on their first post-take ward round by a respiratory consultant physician (group A), non-respiratory consultant physician (group B) or on a Saturday or Sunday (group C).Results: Following exclusions, 426 patients with CAP and 935 patients with cellulitis were analysed. The median LOS for patients with CAP in group A was 1.74 days (n = 123, interquartile range (IQR) 0.97–4.09) compared with 3.03 days for patients in group B (n = 174, IQR 1.12–6.23; p<0.01). There was a larger percentage of discharges within 24 h of consultant review in group A (43.1%) compared with group B (31.9%), although this was not statistically significant (p = 0.18). There was no statistically significant difference between groups A and B with cellulitis in LOS or percentage discharged within 24 h of first consultant review.Conclusion: Patients with non-severe CAP have a shorter hospital LOS when initially seen by a respiratory compared with a non-respiratory physician.