A Critical Evaluation of Pneumonia Mortality in an Internal medicine Service of the “Padre Américo” Hospital – Vale do Sousa

• Autor(a) principal: Castro, Ana Teresa
• Data de Publicação: 2003
• Outros Autores: Carneiro, Rui, Soares, J. A. Freire
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://revista.spmi.pt/index.php/rpmi/article/view/1812
• topic: pneumonia; mortalidade; prognóstico; qualidade assistencial; pneumonia; mortality; prognosis; quality of physician-care

Introduction: Pneumonia is still a serious illness in spite of the use of potent antimicrobialsand effective vaccines. Correct diagnosis and prognostic evaluation are amongst the mostimportant steps for successful management.Goals/ Methods: In this study 126 deaths in patients, in whom the main diagnosis was pneumonia, were characterized. The study period was from 1999 to 2001. Clinical, laboratory, radiographic and microbiological data was collected fromthe records in clinical files. The adequacy of twomethods of assessing prognosis was also evaluated as well as the quality of physician care.Statistics were handled using SSPS 11.0.Results and Discussion: The majority of patients were male and the mean age found was 77.6±11.0 years. The most important adverse prognostic features present in the patients were:respiratory rate>30/minute, admission diastolic blood pressure<60mmHg, mental confusion,acidaemia and urea and creatinine plasmaticlevels above 50 and 1.2 mg/dL, respectively. Nopathogen was identified in 60% of the cases. Asignificant number of patients were categorised as having a bad prognosis by both methodsapplied, making them equally useful in the admission decision process. There was an agreement between the BTS and PORT scales. The initial approach lacked quality in the blood gasand aetiologic evaluation, in the delay in starting antibiotic therapy and in the low rates ofvaccination. The use of a pneumonia protocol is supported.