Management and documentation of pneumonia – a comparison of patients consulting primary care and emergency care
To compare management and documentation of vital signs, symptoms and infection severity in pneumonia patients seeking primary care and emergency care without referral. Medical record review of vital signs, examination findings and severity of pneumonia. Primary and emergency care. Two hundred and fo...
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| Published in | Scandinavian journal of primary health care Vol. 42; no. 2; pp. 338 - 346 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Taylor & Francis LLC
2024
Taylor & Francis Taylor & Francis Group |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0281-3432 1502-7724 1502-7724 |
| DOI | 10.1080/02813432.2024.2326469 |
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| Abstract | To compare management and documentation of vital signs, symptoms and infection severity in pneumonia patients seeking primary care and emergency care without referral.
Medical record review of vital signs, examination findings and severity of pneumonia.
Primary and emergency care.
Two hundred and forty patients diagnosed with pneumonia.
Vital signs, examination findings and severity of pneumonia. Assessments of pneumonia severity according to the reviewers, the traffic light score and CRB-65.
Respiratory rate, blood pressure, heart rate and oxygen saturation were less often documented in primary care (
< .001). Chest X-ray was performed in 5% of primary care patients vs. 88% of emergency care patients (
< .01). Primary care patients had longer symptom duration, higher oxygen saturation and lower respiratory rate. In total, the reviewers assessed 63% of all pneumonias as mild and 9% as severe. The traffic light scoring model identified 11 patients (9%) in primary care and 53 patients (44%) in emergency care at high risk of severe infection.
Vital signs were documented less often in primary care than in emergency care. Patients in primary care appear to have a less severe pneumonia, indicating attendance to the correct care level. The traffic light scoring model identified more patients at risk of severe infection than CRB-65, where the parameters were documented to a limited extent. |
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| AbstractList | To compare management and documentation of vital signs, symptoms and infection severity in pneumonia patients seeking primary care and emergency care without referral.OBJECTIVETo compare management and documentation of vital signs, symptoms and infection severity in pneumonia patients seeking primary care and emergency care without referral.Medical record review of vital signs, examination findings and severity of pneumonia.DESIGNMedical record review of vital signs, examination findings and severity of pneumonia.Primary and emergency care.SETTINGPrimary and emergency care.Two hundred and forty patients diagnosed with pneumonia.SUBJECTSTwo hundred and forty patients diagnosed with pneumonia.Vital signs, examination findings and severity of pneumonia. Assessments of pneumonia severity according to the reviewers, the traffic light score and CRB-65.MAIN OUTCOME MEASURESVital signs, examination findings and severity of pneumonia. Assessments of pneumonia severity according to the reviewers, the traffic light score and CRB-65.Respiratory rate, blood pressure, heart rate and oxygen saturation were less often documented in primary care (p < .001). Chest X-ray was performed in 5% of primary care patients vs. 88% of emergency care patients (p < .01). Primary care patients had longer symptom duration, higher oxygen saturation and lower respiratory rate. In total, the reviewers assessed 63% of all pneumonias as mild and 9% as severe. The traffic light scoring model identified 11 patients (9%) in primary care and 53 patients (44%) in emergency care at high risk of severe infection.RESULTSRespiratory rate, blood pressure, heart rate and oxygen saturation were less often documented in primary care (p < .001). Chest X-ray was performed in 5% of primary care patients vs. 88% of emergency care patients (p < .01). Primary care patients had longer symptom duration, higher oxygen saturation and lower respiratory rate. In total, the reviewers assessed 63% of all pneumonias as mild and 9% as severe. The traffic light scoring model identified 11 patients (9%) in primary care and 53 patients (44%) in emergency care at high risk of severe infection.Vital signs were documented less often in primary care than in emergency care. Patients in primary care appear to have a less severe pneumonia, indicating attendance to the correct care level. The traffic light scoring model identified more patients at risk of severe infection than CRB-65, where the parameters were documented to a limited extent.CONCLUSIONSVital signs were documented less often in primary care than in emergency care. Patients in primary care appear to have a less severe pneumonia, indicating attendance to the correct care level. The traffic light scoring model identified more patients at risk of severe infection than CRB-65, where the parameters were documented to a limited extent. Patients may attend either primary or emergency care without referral in Sweden. Guidelines recommend a severity assessment, including assessment of vital signs, to be performed for all patients presenting with suspected pneumonia. Pneumonia patients attending primary care have less affected vital signs than those attending emergency care. Vital signs were less documented in primary care than in emergency care. Patients with pneumonia seem to attend the correct level of care when they have the possibility to choose without a referral. CRB-65 was not possible to count in most primary care patients due to lack of documentation. Patients may attend either primary or emergency care without referral in Sweden. Guidelines recommend a severity assessment, including assessment of vital signs, to be performed for all patients presenting with suspected pneumonia. Objective To compare management and documentation of vital signs, symptoms and infection severity in pneumonia patients seeking primary care and emergency care without referral. Design Medical record review of vital signs, examination findings and severity of pneumonia. Setting Primary and emergency care. Subjects Two hundred and forty patients diagnosed with pneumonia. Main outcome measures Vital signs, examination findings and severity of pneumonia. Assessments of pneumonia severity according to the reviewers, the traffic light score and CRB-65. Results Respiratory rate, blood pressure, heart rate and oxygen saturation were less often documented in primary care (p &lt; .001). Chest X-ray was performed in 5% of primary care patients vs. 88% of emergency care patients (p &lt; .01). Primary care patients had longer symptom duration, higher oxygen saturation and lower respiratory rate. In total, the reviewers assessed 63% of all pneumonias as mild and 9% as severe. The traffic light scoring model identified 11 patients (9%) in primary care and 53 patients (44%) in emergency care at high risk of severe infection. Conclusions Vital signs were documented less often in primary care than in emergency care. Patients in primary care appear to have a less severe pneumonia, indicating attendance to the correct care level. The traffic light scoring model identified more patients at risk of severe infection than CRB-65, where the parameters were documented to a limited extent. Patients may attend either primary or emergency care without referral in Sweden. Guidelines recommend a severity assessment, including assessment of vital signs, to be performed for all patients presenting with suspected pneumonia. Objective: To compare management and documentation of vital signs, symptoms and infection severity in pneumonia patients seeking primary care and emergency care without referral. Design: Medical record review of vital signs, examination findings and severity of pneumonia. Setting: Primary and emergency care. Subjects: Two hundred and forty patients diagnosed with pneumonia. Main outcome measures: Vital signs, examination findings and severity of pneumonia. Assessments of pneumonia severity according to the reviewers, the traffic light score and CRB-65. Results: Respiratory rate, blood pressure, heart rate and oxygen saturation were less often documented in primary care (p < .001). Chest X-ray was performed in 5% of primary care patients vs. 88% of emergency care patients (p < .01).Primary care patients had longer symptom duration, higher oxygen saturation and lower respiratory rate. In total, the reviewers assessed 63% of all pneumonias as mild and 9% as severe. The traffic light scoring model identified 11 patients (9%) in primary care and 53 patients (44%) in emergency care at high risk of severe infection. Conclusions: Vital signs were documented less often in primary care than in emergency care. Patients in primary care appear to have a less severe pneumonia, indicating attendance to the correct care level. The traffic light scoring model identified more patients at risk of severe infection than CRB-65, where the parameters were documented to a limited extent. To compare management and documentation of vital signs, symptoms and infection severity in pneumonia patients seeking primary care and emergency care without referral. Medical record review of vital signs, examination findings and severity of pneumonia. Primary and emergency care. Two hundred and forty patients diagnosed with pneumonia. Vital signs, examination findings and severity of pneumonia. Assessments of pneumonia severity according to the reviewers, the traffic light score and CRB-65. Respiratory rate, blood pressure, heart rate and oxygen saturation were less often documented in primary care ( < .001). Chest X-ray was performed in 5% of primary care patients vs. 88% of emergency care patients ( < .01). Primary care patients had longer symptom duration, higher oxygen saturation and lower respiratory rate. In total, the reviewers assessed 63% of all pneumonias as mild and 9% as severe. The traffic light scoring model identified 11 patients (9%) in primary care and 53 patients (44%) in emergency care at high risk of severe infection. Vital signs were documented less often in primary care than in emergency care. Patients in primary care appear to have a less severe pneumonia, indicating attendance to the correct care level. The traffic light scoring model identified more patients at risk of severe infection than CRB-65, where the parameters were documented to a limited extent. AbstractPatients may attend either primary or emergency care without referral in Sweden. Guidelines recommend a severity assessment, including assessment of vital signs, to be performed for all patients presenting with suspected pneumonia.Objective To compare management and documentation of vital signs, symptoms and infection severity in pneumonia patients seeking primary care and emergency care without referral.Design Medical record review of vital signs, examination findings and severity of pneumonia.Setting Primary and emergency care.Subjects Two hundred and forty patients diagnosed with pneumonia.Main outcome measures Vital signs, examination findings and severity of pneumonia. Assessments of pneumonia severity according to the reviewers, the traffic light score and CRB-65.Results Respiratory rate, blood pressure, heart rate and oxygen saturation were less often documented in primary care (p < .001). Chest X-ray was performed in 5% of primary care patients vs. 88% of emergency care patients (p < .01). Primary care patients had longer symptom duration, higher oxygen saturation and lower respiratory rate. In total, the reviewers assessed 63% of all pneumonias as mild and 9% as severe. The traffic light scoring model identified 11 patients (9%) in primary care and 53 patients (44%) in emergency care at high risk of severe infection.Conclusions Vital signs were documented less often in primary care than in emergency care. Patients in primary care appear to have a less severe pneumonia, indicating attendance to the correct care level. The traffic light scoring model identified more patients at risk of severe infection than CRB-65, where the parameters were documented to a limited extent. Patients may attend either primary or emergency care without referral in Sweden. Guidelines recommend a severity assessment, including assessment of vital signs, to be performed for all patients presenting with suspected pneumonia.ObjectiveTo compare management and documentation of vital signs, symptoms and infection severity in pneumonia patients seeking primary care and emergency care without referral.DesignMedical record review of vital signs, examination findings and severity of pneumonia.SettingPrimary and emergency care.SubjectsTwo hundred and forty patients diagnosed with pneumonia.Main outcome measuresVital signs, examination findings and severity of pneumonia. Assessments of pneumonia severity according to the reviewers, the traffic light score and CRB-65.ResultsRespiratory rate, blood pressure, heart rate and oxygen saturation were less often documented in primary care (p < .001). Chest X-ray was performed in 5% of primary care patients vs. 88% of emergency care patients (p < .01). Primary care patients had longer symptom duration, higher oxygen saturation and lower respiratory rate. In total, the reviewers assessed 63% of all pneumonias as mild and 9% as severe. The traffic light scoring model identified 11 patients (9%) in primary care and 53 patients (44%) in emergency care at high risk of severe infection.ConclusionsVital signs were documented less often in primary care than in emergency care. Patients in primary care appear to have a less severe pneumonia, indicating attendance to the correct care level. The traffic light scoring model identified more patients at risk of severe infection than CRB-65, where the parameters were documented to a limited extent. |
| Author | Berger, Ann-Sofie Arntsberg, Louise Moberg, Anna Hedin, Katarina Fernberg, Sara |
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| Cites_doi | 10.1111/j.1469-0691.2011.03602.x 10.3399/BJGP.2021.0633 10.1186/s13049-021-00905-2 10.3390/antibiotics12071165 10.3399/bjgp12X656810 10.5455/medarh.2013.67.442-445 10.3399/bjgp08x279689 10.3238/arztebl.2017.0838 10.1183/09031936.96.09081596 10.1080/00365540310018842 10.1136/thx.2009.121434 10.3399/bjgp10X532422 10.2147/POR.S211198 10.4104/pcrj.2011.00083 10.3399/bjgpopen20X101015 10.1136/thx.2006.069740 10.1016/j.mcna.2018.12.008 10.4104/pcrj.2013.00093 |
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| Copyright | 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This work is licensed under the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. 2024 The Author(s) |
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| References_xml | – ident: e_1_3_5_8_1 doi: 10.1111/j.1469-0691.2011.03602.x – ident: e_1_3_5_10_1 doi: 10.3399/BJGP.2021.0633 – ident: e_1_3_5_19_1 doi: 10.1186/s13049-021-00905-2 – ident: e_1_3_5_7_1 doi: 10.3390/antibiotics12071165 – volume: 68 start-page: 1 issue: 6 year: 2019 ident: e_1_3_5_2_1 article-title: Deaths: leading causes for 2017 publication-title: Natl Vital Stat Rep – ident: e_1_3_5_13_1 doi: 10.3399/bjgp12X656810 – ident: e_1_3_5_23_1 doi: 10.5455/medarh.2013.67.442-445 – ident: e_1_3_5_14_1 doi: 10.3399/bjgp08x279689 – volume: 19 start-page: 49 issue: 3 year: 2008 ident: e_1_3_5_5_1 article-title: Lower respiratory tract infection [Nedre luftvägsinfektioner] publication-title: Information från Läkemedelsverket – ident: e_1_3_5_16_1 doi: 10.3238/arztebl.2017.0838 – ident: e_1_3_5_21_1 doi: 10.1183/09031936.96.09081596 – ident: e_1_3_5_11_1 – ident: e_1_3_5_22_1 doi: 10.1080/00365540310018842 – ident: e_1_3_5_3_1 doi: 10.1136/thx.2009.121434 – ident: e_1_3_5_9_1 doi: 10.3399/bjgp10X532422 – ident: e_1_3_5_24_1 doi: 10.2147/POR.S211198 – ident: e_1_3_5_15_1 doi: 10.4104/pcrj.2011.00083 – ident: e_1_3_5_20_1 doi: 10.3399/bjgpopen20X101015 – ident: e_1_3_5_17_1 doi: 10.1136/thx.2006.069740 – ident: e_1_3_5_18_1 doi: 10.1016/j.mcna.2018.12.008 – volume: 88 start-page: 621 issue: 6 year: 2017 ident: e_1_3_5_4_1 article-title: Community-acquired pneumonia publication-title: Radiol Technol – ident: e_1_3_5_6_1 doi: 10.4104/pcrj.2013.00093 – ident: e_1_3_5_12_1 |
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| Snippet | To compare management and documentation of vital signs, symptoms and infection severity in pneumonia patients seeking primary care and emergency care without... Patients may attend either primary or emergency care without referral in Sweden. Guidelines recommend a severity assessment, including assessment of vital... AbstractPatients may attend either primary or emergency care without referral in Sweden. Guidelines recommend a severity assessment, including assessment of... |
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| SubjectTerms | Anestesi och intensivvård Anesthesiology and Intensive Care Blood pressure Chest Clinical Medicine Documentation emergency care Emergency medical care Emergency services Heart rate High risk Infections Klinisk medicin Medical and Health Sciences Medical referrals Medicin och hälsovetenskap Oxygen Oxygen saturation Patients Pneumonia Primary care Saturation Severity severity scoring Vital signs |
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| Title | Management and documentation of pneumonia – a comparison of patients consulting primary care and emergency care |
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