[Are short stay medical units an appropriate place to manage community-acquired pneumonia?].
INTRODUCTION: Evaluate patients with community acquired pneumonia (CAP) admitted to our Short Stay Medical Unit (SSMU) in order to establish, using Fines s criteria, whether reducing the length of stay of maximum risk groups (IV and V) is associated with reduction of quality with either an increase of mortality or readmissions. A further objective was to pinpoint the variables associated with a prolongation of hospital stay. PATIENTS AND METHODS: All CAP patients admitted to our unit over a eighteen-month period were included in the study. We conducted an univariate analysis and a step wise multivariate analysis of all the variables in the univariate analysis showing a significant statistical relation. RESULTS: 182 patients with a mean age of 73 years were studied. The length of hospital stay was 4.3 days. Stratified by Fine's criteria, 91.2% were included in the groups of maximum risk: 12.1% in group III, 60.4% IV and 18.7% in V. The medium length of stay for each category was 4.3, 4.1 y 5.3 days respectively. The mortality rate was 2.7% and only 5 patients required readmission within one month alter the discharge. Of the variables analyzed only Fine's group V, chronic liver disease and/or renal insufficiency as comorbidities, a pulse rate over 125 per minute and blood glucose level > 250 mg/l showed a significant relation with more than five days hospitalization, and out of them, only the three latter stayed in the multivariate analysis. CONCLUSIONS: All CAP patients, including those in Fine's groups IV and V, can be treated safely and efficiently in a SSMU, providing there is an outpatient clinic for immediate consultation available.