Standardized Emergency Care for Community Acquired Pneumonia (CAP)

Sponsor

Klinikum Nürnberg (Other)

Overall Status

Completed

CT.gov ID

NCT01963000

Collaborator

(none)

2,819

Enrollment

Location

Duration (Months)

39.7

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

Community acquired pneumonia (CAP) is associated with a high in-hospital mortality. Standardization of diagnostics and adherence to sepsis bundles in the emergency department (ED) are associated with reduced mortality in patients with sepsis. Investigators examined whether the introduction of standardized care bundles and check lists in the ED are associated with a reduced mortality rate in patients hospitalized for CAP.

This is an observational trial. The investigators retrospectively analyzed performance indicators of 2819 consecutive patients with CAP admitted to the Nuremberg Hospital, Germany, from 2008 to 2009. At the turn of the year, implementation of CAP care bundles took place including interprofessional education, checklists and institutionalized feedback. Primary endpoint was in-hospital mortality of CAP patients. After the implementation of CAP care bundles in the ED, mortality of affected patients was significantly lower in 2009 compared to 2008. This study should demonstrate that the implementation of a standardized CAP care bundle in the ED is associated with a risk reduction in affected patients. Standardization of diagnostic and therapeutic processes in the ED therefore improves the outcome of patients hospitalized for CAP.

Condition or Disease	Intervention/Treatment	Phase
Community Acquired Pneumonia Pneumonia Infection

Study Design

Study Type:

Observational

Actual Enrollment :

2819 participants

Observational Model:

Cohort

Time Perspective:

Retrospective

Official Title:

Reduction of Mortality in Community-Acquired Pneumonia After Implementing Standardized Care Bundles in the Emergency Department

Study Start Date :

Jan 1, 2007

Actual Primary Completion Date :

Dec 1, 2012

Actual Study Completion Date :

Dec 1, 2012

Arms and Interventions

Arm	Intervention/Treatment
CAP A patient with CAP was identified by encoding pneumonia without severe immunosuppression (HIV infection, solid organ or bone marrow/stem cell transplants, severe neutropenia) as the main diagnosis (ICD 10 GM) of hospital admission.

Outcome Measures

Primary Outcome Measures

mortality of CAP patients [up to 14days]

Secondary Outcome Measures

mortality up to 14days in subgroups [up to 14 days]
Mortality of patients upt to 14day is determined in subgroups (different age groups, sub-groups of CRB-risk classes) CRB-65: C mental confusion; R respiratory rate ≥30/min; B systolic blood pressure <90 mm Hg; 65, age ≥65 years