Universal Journal of Clinical Medicine Vol. 1(1), pp. 1 - 5
DOI: 10.13189/ujcm.2013.010101
Reprint (PDF) (160Kb)


Time to Antibiotics and Hospital Length of Stay in Emergency Department Patients Admitted for Pneumonia: A Retrospective, Cross-Sectional Analysis


Hany Y Atallah MD*, Dilani Weerasuriya MD, Jeremy Hess MD MPH, Debra Houry MD MPH, Daniel Wu MD, Leon L Haley Jr.,MD,MHSA
Department of Emergency Medicine, Emory University School of Medicine, Atlanta, 30303, Georgia, United States

ABSTRACT

Background: Studies have reported mixed findings regarding timing of antibiotic delivery in patients admitted for pneumonia and clinical outcomes. We hypothesized that there is no association between the time to antibiotics and the hospital length of stay (LOS) for patients admitted from the emergency department (ED) to the hospital for pneumonia. Objective: To compare the hospital LOS of patients admitted from the ED to the hospital for pneumonia based on the interval between ED arrival and first dose of antibiotics categorized to four hours or less, four to six hours, and greater than six hours. Methods: We conducted a retrospective chart review at a single inner city ED on patients who had admitting and discharge diagnoses of pneumonia and received antibiotics in the ED over a 17 month period. Using structured abstraction sheets, a trained reviewer identified cases and abstracted data on hospital LOS, time of arrival to first antibiotic dose, admission bed type, and other patient factors. The primary outcome was hospital LOS. Data were analyzed using descriptive statistics, ANOVA, and linear regression. Results: Nine hundred ninety nine cases were identified and541 met inclusion criteria. Four hundred eighty three (89%) were African American, 240 (44%) were female, the average age was 52 years old (SD 15), and 186 (34%) were HIV positive. There was no significant difference in LOS based on time to antibiotics. Controlling for patient factors including pneumonia type (community or health care associated) did not result in a significant difference in LOS across the time to antibiotic categories. Conclusions: In this population of pneumonia patients admitted to the hospital from the ED, time to first antibiotic dose was not significantly correlated with hospital LOS. Controlling for demographics and disease severity did not affect the observed relationship.

KEYWORDS
Pneumonia, Length of Stay, Antibiotics

Cite this paper
Hany Y Atallah MD , Dilani Weerasuriya MD , Jeremy Hess MD MPH , Debra Houry MD MPH , Daniel Wu MD , Leon L Haley Jr.,MD,MHSA . "Time to Antibiotics and Hospital Length of Stay in Emergency Department Patients Admitted for Pneumonia: A Retrospective, Cross-Sectional Analysis." Universal Journal of Clinical Medicine 1.1 (2013) 1 - 5. doi: 10.13189/ujcm.2013.010101.