@article{JTD13801,
author = {Pedro J. Marcos and Marcos I. Restrepo and Francisco J. González-Barcala and Nilam J. Soni and Iria Vidal and Pilar Sanjuàn and Diego Llinares and Lucía Ferreira-Gonzalez and Carlos Rábade and Isabel Otero-González and Pedro Marcos and Héctor Verea-Hernando},
title = {Discordance of physician clinical judgment vs . pneumonia severity index (PSI) score to admit patients with low risk community-acquired pneumonia: a prospective multicenter study},
journal = {Journal of Thoracic Disease},
volume = {9},
number = {6},
year = {2017},
keywords = {},
abstract = {Background: The relationship between clinical judgment and the pneumonia severity index (PSI) score in deciding the site of care for patients with community-acquired pneumonia (CAP) has not been well investigated. The objective of the study was to determine the clinical factors that influence decision-making to hospitalize low-risk patients (PSI ≤2) with CAP.
Methods: An observational, prospective, multicenter study of consecutive CAP patients was performed at five hospitals in Spain. Patients admitted with CAP and a PSI ≤2 were identified. Admitting physicians completed a patient-specific survey to identify the clinical factors influencing the decision to admit a patient. The reason for admission was categorized into 1 of 6 categories. We also assessed whether the reason for admission was associated with poorer clinical outcomes [intensive care unit (ICU) admission, 30-day mortality or readmission].
Results: One hundred and fifty-five hospitalized patients were enrolled. Two or more reasons for admission were seen in 94 patients (60.6%), including abnormal clinical test results (60%), signs of clinical deterioration (43.2%), comorbid conditions (28.4%), psychosocial factors (28.4%), suspected H1N1 pneumonia (20.6%), and recent visit to the emergency department (ED) in the past 2 weeks (7.7%). Signs of clinical deterioration and abnormal clinical test results were associated with poorer clinical outcomes (P},
issn = {2077-6624}, url = {https://jtd.amegroups.org/article/view/13801}
}