The emergency department community-acquired pneumonia trial

Yealy, Donald M.; Auble, Thomas E.; Stone, Roslyn A.; Lave, Judith R.; Meehan, Thomas P.; Graff, Louis; Fine, Jonathan; Obrosky, D. Scott; Edick, Stacey; Hough, Linda J.; Tuozzo, Kathy; Fine, Michael J.

doi:10.1016/j.annemergmed.2003.09.013

Cited by 41 publications

(12 citation statements)

References 25 publications

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“…23 Study sites were randomized to low-intensity (n = 8), moderate-intensity (n = 12), or high-intensity (n = 12) guideline implementation strategies to promote performance of evidence-based processes of care for pneumonia and to use the Pneumonia Severity Index (PSI) to guide the initial site of treatment decision. The PSI is a validated prediction rule for pneumonia prognosis that stratifies patients into 5 classes of risk for mortality.…”

Section: Methodsmentioning

confidence: 99%

“…EDCAP study methods and findings on the interventions’ effectiveness and safety have been reported. 23,25 …”

Section: Methodsmentioning

confidence: 99%

“…We studied the associations between the performance of evidence-based processes of care and short-term mortality and other medical outcomes in patients hospitalized with pneumonia in the Emergency Department Community-Acquired Pneumonia (EDCAP) Trial. 23 …”

mentioning

confidence: 99%

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Processes of Care and Outcomes for Community-Acquired Pneumonia

Lee¹,

Primack²,

Mor³

et al. 2011

The American Journal of Medicine

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BACKGROUND Although processes of care are common proxies for health care quality, their associations with medical outcomes remain uncertain. METHODS For 2076 patients hospitalized with pneumonia from 32 emergency departments, we used multilevel logistic regression modeling to assess independent associations between patient outcomes and the performance of 4 individual processes of care (assessment of oxygenation, blood cultures, and rapid initiation [<4 hours] and appropriate selection of antibiotic therapy) and the cumulative number of processes of care performed. RESULTS Overall, 141 patients (6.8%) died. Mortality was 0.3% to 1.7% lower for patients who had each of the individual processes of care performed (P ≥ .13 for each comparison); mortality was 7.5% for patients who had 0 to 2 processes of care, 7.2% for those with 3 processes of care, and 5.8% for those with all 4 processes of care performed (P = .39). Mortality was not significantly associated with either individual or cumulative process measures in multivariable models. CONCLUSION Neither the individual processes of care nor the cumulative number performed is associated with short-term mortality for pneumonia.

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Section: Methodsmentioning

confidence: 99%

“…EDCAP study methods and findings on the interventions’ effectiveness and safety have been reported. 23,25 …”

Section: Methodsmentioning

confidence: 99%

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Processes of Care and Outcomes for Community-Acquired Pneumonia

Lee¹,

Primack²,

Mor³

et al. 2011

The American Journal of Medicine

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“…The EDCAP trial is a 32‐site cluster‐randomized trial designed to compare the effectiveness and safety of 3 emergency department‐level interventions to use the PSI to guide the initial site of treatment of patients with pneumonia 11 . In this trial, outpatient treatment was recommended for all low‐risk patients, defined as those in PSI risk classes I‐III with no evidence of arterial oxygen desaturation (oxygen saturation <90% or oxygen tension <60 mmHg).…”

Section: Methodsmentioning

confidence: 99%

“…In this trial, outpatient treatment was recommended for all low‐risk patients, defined as those in PSI risk classes I‐III with no evidence of arterial oxygen desaturation (oxygen saturation <90% or oxygen tension <60 mmHg). Inpatient treatment was recommended for all patients with evidence of oxygen desaturation and/or patients in risk classes IV or V (i.e., higher‐risk patients) 6,11 …”

Section: Methodsmentioning

confidence: 99%

Factors associated with the hospitalization of low-risk patients with community-acquired pneumonia in a cluster-randomized trial

et al. 2006

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Hospital admission appears justified for one-third of low-risk inpatients based upon the presence of one or more contraindications to outpatient treatment. At least one-fifth of low-risk inpatients did not have a contraindication to outpatient treatment or an identifiable risk factor for hospitalization, suggesting that treatment of a larger proportion of such low-risk patients in the outpatient setting could be achieved without adversely affecting patient outcomes.

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Analysis of Outcomes Associated With Outpatient Management of Nonoperatively Treated Patients With Appendicitis

et al. 2022

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IMPORTANCEIn the Comparison of Outcomes of Antibiotic Drugs and Appendectomy (CODA) trial, which found antibiotics to be noninferior, approximately half of participants randomized to receive antibiotics had outpatient management with hospital discharge within 24 hours. If outpatient management is safe, it could increase convenience and decrease health care use and costs. OBJECTIVE To assess the use and safety of outpatient management of acute appendicitis. DESIGN, SETTING, AND PARTICIPANTS This cohort study, which is a secondary analysis of the CODA trial, included 776 adults with imaging-confirmed appendicitis who received antibiotics at 25

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The emergency department community-acquired pneumonia trial

Cited by 41 publications

References 25 publications

Processes of Care and Outcomes for Community-Acquired Pneumonia

Processes of Care and Outcomes for Community-Acquired Pneumonia

Factors associated with the hospitalization of low-risk patients with community-acquired pneumonia in a cluster-randomized trial

Analysis of Outcomes Associated With Outpatient Management of Nonoperatively Treated Patients With Appendicitis

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