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Master Thesis

Hospitalisation par admission directe en cas de pneumopathie aiguë communautaire. Étude rétrospective de la durée moyenne de séjour dans le service de médecine polyvalente du Centre Hospitalier Sud-Gironde et comparaison avec l'admission par les urgences

Abstract : Introduction: hospitalization by direct admission (DA) instead of admission through emergency (EA) is recommended for patients with vulnerability but there is a risk of delay in the management of acute medical disease. The comparison between these two ways of admission is scarce in the literature, particularly when the patient is admitted for community-acquired pneumonia (CAP). Objectives: to compare the length of stay (LOS), mortality rate, general management and characteristics of the patients hospitalized for CAP in the medicine department of Sud-Gironde Hospital (France), depending on the way of admission (DA vs EA). Methods: we analyzed retrospectively the medical files of all the patients directly admitted for CAP in the medicine department, from January 2014 to May 2019, and we compared them with a randomized group of patients admitted through emergency in the same hospital. The primary outcome was LOS. We excluded patients with intensive-care unit admission criterias. There was no follow up after leaving. Results: The patients directly admitted represented 19,8% of all the hospitalizations for low respiratory infections. We included 182 patients with CAP (mean age 81 years, 55% of women), 79 where DA and we compare them with 103 EA. The mean LOS was 9,84 days without differences between the two ways of admission (p=0,49). Mortality rate in case of DA was not significatively augmented (OR=1,3; 95% CI 0,6-2,7). The management (antibiotherapy, paraclinical examinations) and population characteristics were nearly equivalent. Conclusion: when a hospitalization is needed for a patient with CAP, DA to the medecine department of Sud-Gironde Hospital was an equivalent strategy to admission through emergency.
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https://dumas.ccsd.cnrs.fr/dumas-02947047
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Wednesday, September 23, 2020 - 4:05:49 PM
Last modification on : Wednesday, October 14, 2020 - 4:21:36 AM

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Philippe Marqueton. Hospitalisation par admission directe en cas de pneumopathie aiguë communautaire. Étude rétrospective de la durée moyenne de séjour dans le service de médecine polyvalente du Centre Hospitalier Sud-Gironde et comparaison avec l'admission par les urgences. Sciences du Vivant [q-bio]. 2020. ⟨dumas-02947047⟩

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