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Submitted: 11 October 2012
HERDIN Record #: R04A-DLSHSI-12101110273342

Adherence to the clinical practice guideline in the management of adults with hospitalized Community Acquired Pneumonia.

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Objectives: To determine whether the diagnosis, categorization of the severity and choice of initial antimicrobial agent for hospitalized community acquired pneumonia is guided by the clinical practice guideline.

To determine whether adherence to the clinical practice guideline affects outcome in terms of:
1. Duration of hospital stay
2. Time to clinical stability
3. Deaths which may be defined as:
a. In hospital mortality attributable to pneumonia
b. Home against medical advice in which patients are on ventilatory support or transfer to other hospitals on ventilatory support
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DESIGN: Retrospective cohort

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SETTING: University Affiliated Tertiary Medical Center

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SUBJECTS: All patients 18 years old with symptoms suggestive of pneumonia and with a radiographic evidence of pneumonia.

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METHODOLOGY: A retrospective analytic review of 168 cases of hospitalized community acquired pneumonia of patients 18 years old and above, from January 1999 to December 1999, with a sample size of 84 cases per group using an L = 0.05 and B = 0.02 expected frequency of mortality at 25% for those not following the guideline versus 7.9% for those who follow the guideline. Outcome variables were measured using the chi-square test or the Fischer exact test to determine significant difference of proportion between specified groups. The association was considered statistically significant if p < 0.05.

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RESULTS: There is no significant difference between in the 3 outcome variables when tested between individual category. However, over-all evaluation, combining all categories revealed significant difference in over-all survival for those adhering to the clinical practice guideline than those who are not.



Objectives

To determine whether the diagnosis, categorization of the severity and choice of initial antimicrobial agent for hospitalized community acquired pneumonia is guided by the clinical practice guideline.

To determine whether adherence to the clinical practice guideline affects outcome in terms of:
1. Duration of hospital stay
2. Time to clinical stability
3. Deaths which may be defined as:
a. In hospital mortality attributable to pneumonia
b. Home against medical advice in which patients are on ventilatory support or transfer to other hospitals on ventilatory support

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