Influence of the adequacy of data collection, during two years, in the management of community-acquired pneumonia in emergency departments

Objective. The aim of this study was to analyze whether structured data collec-tion of patients with community-acquired pneumonia (CAP) in the Emergency De-partment (ED) improves compliance with clinical guidelines regarding inpatient and outpatient treatment and prescription of antibiotics at discharge. Material and methods. We performed a quasi experimental, multicenter, pre/post-intervention study. The intervention con-sisted of basic training for the participat-ing physicians and the incorporation of a data collection sheet in the clinical history chart, including the information neces-sary for adequate decision making re-garding patient admission and treatment, in the case of discharge. We analyzed the adequacy of the final destination of pa-tients classified as Fine I-II and antibiotic treatment in patients receiving outpatient treatment, with each participating physi-cian including 8 consecutive patients (4 pre-intervention and 4 post-intervention). Results. A total of 738 patients were in-cluded: 378 pre-intervention and 360 post-intervention. In the pre-intervention group, Fine V was more frequent and pa-tients were older, had more ischemic heart disease, active neoplasms and fewer risk factors for atypical pneumonia. Of the patients with Fine I-II, 23.7% were in-adequately admitted and 19.6% of those discharged received treatment not rec-ommended by guidelines. No differences were observed in the target variables be-tween the two groups. Conclusion. The adequacy of the decision to admit patients with Fine I-II CAP and outpatient antibiotic treatment can be im-proved in the ED. Structured data collec-tion does not improve patient outcome.