Comparison of Patients with Community-Acquired Pneumonia Who Did and Did not Receive Treatment in Accordance with the 2009 Pneumonia Guideline of Turkish Thoracic Society

Turk Thorac J. 2015 Apr;16(2):64-67. doi: 10.5152/ttd.2015.4437. Epub 2015 Apr 1.

Abstract

Objectives: The purpose of our study was to compare community-acquired pneumonia (CAP) patients who were and were not administered treatment in accordance with the Turkish Thoracic Society (TTS) 2009 pneumonia guideline in terms of hospital stay length, treatment cost, and treatment efficacy.

Material and methods: Patients who were admitted to our hospital and who were diagnosed with CAP were included in the study. Demographic characteristics of the patients, symptoms at the time of diagnosis, physical examination, laboratory and radiological findings, treatments, response to treatment at follow-up, length of hospital stay, and direct cost of treatment were recorded in the TTS pneumonia database (TURCAP: TURKEY Community Acquired Pneumonia). Taking into consideration the "Turkish Thoracic Society Consensus Report on the Diagnosis and Treatment of Community-acquired pneumonia in Adults (2009)," the patients recorded in the database were evaluated in terms of conformity to the guideline.

Results: This present study included 156 patients diagnosed with CAP. Sixty-six patients (42.3%) were females, and 96 (57.7%) were males, and the mean age of the patients was 70.4 years. The most common symptoms on admission were cough (94.9%), expectoration of purulent sputum (77.6%), and fever (58%). Comorbid diseases were chronic obstructive pulmonary disease (COPD; 29.5%), asthma (3.2%), lung cancer (8.3%), cardiovascular diseases (32.7%), and diabetes mellitus (12.8%). It was observed that 67.3% of the patients received treatment in accordance with the guideline. No significant difference was found in terms of gender and symptoms between the groups that received and did not receive treatment in accordance with the guideline. The mean age of the patients who received treatment according to the guideline was higher than that of the patients who did not receive treatment according to the guideline; COPD was more frequent in the group of patients who received treatment according to the guideline. Pneumonia Severity Index and Confusion, Urea, Respiratory rate, Blood pressure-Age>65 scores of the patients who were treated according to the guideline was higher and treatment resulted in death in 8% of these patients.

Conclusion: Hospital stay length, treatment cost, and treatment efficacy were similar in patients who were and were not administered treatment in accordance with the guideline.

Keywords: Community-acquired pneumonia; adherence with guideline; pneumonia treatment guideline.