Management and documentation of pneumonia–a comparison of patients consulting primary care and emergency care
(2024) In Scandinavian Journal of Primary Health Care- Abstract
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... (More)
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.
(Less)
- author
- Arntsberg, Louise ; Fernberg, Sara ; Berger, Ann Sofie ; Hedin, Katarina LU and Moberg, Anna
- organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- epub
- subject
- keywords
- emergency care, Pneumonia, primary care, severity scoring, vital signs
- in
- Scandinavian Journal of Primary Health Care
- publisher
- Taylor & Francis
- external identifiers
-
- pmid:38459974
- scopus:85187147202
- ISSN
- 0281-3432
- DOI
- 10.1080/02813432.2024.2326469
- language
- English
- LU publication?
- yes
- id
- 8628e096-942f-4e9e-b128-544deba8639b
- date added to LUP
- 2024-03-28 09:42:10
- date last changed
- 2024-04-25 13:40:18
@article{8628e096-942f-4e9e-b128-544deba8639b,
abstract = {{<p>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.</p>}},
author = {{Arntsberg, Louise and Fernberg, Sara and Berger, Ann Sofie and Hedin, Katarina and Moberg, Anna}},
issn = {{0281-3432}},
keywords = {{emergency care; Pneumonia; primary care; severity scoring; vital signs}},
language = {{eng}},
publisher = {{Taylor & Francis}},
series = {{Scandinavian Journal of Primary Health Care}},
title = {{Management and documentation of pneumonia–a comparison of patients consulting primary care and emergency care}},
url = {{http://dx.doi.org/10.1080/02813432.2024.2326469}},
doi = {{10.1080/02813432.2024.2326469}},
year = {{2024}},
}