In a new study, researchers found that patients with community-acquired pneumonia (CAP), who are unable to walk when admitted to the hospital, have a greater risk of death while in the hospital. In a study of 3,043 patients with CAP admitted to six hospitals in Edmonton, Alberta, Canada, researchers from the University of Alberta found that patients in a wheelchair at time of hospital admission were 1.4 times more likely to die during their hospital stay than those who were able to walk; and patients who were bedridden when admitted to the hospital were 4 times more likely to die while hospitalized, when compared to patients who could walk. Researchers also found that drug therapy with levofloxacin only significantly decreased a patient's late mortality rate but had no effect on early mortality. Other factors that significantly influenced the mortality rate in this population were pneumonia severity of illness score, site of care, and consultation by a respirologist or infectious disease physician. The study appears in the April issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.
Hospital's Equipment Repair Costs Reduced by New Programs
The introduction of an interventional pulmonary (IP) program and an educational program dramatically reduced equipment repair costs for endoscopes and associated equipment at Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. In the three years prior to the start of the IP program, the hospital's average daily repair cost was $42 per procedure. After the IP program was introduced to the hospital, repair costs rose 21 percent, to $51 per procedure. The hospital then implemented an educational program to enhance the skills of physicians and the technical staff handling the equipment. The program included a one-day course in bronchoscopic and IP equipment, including half day of lectures and questions-and-answers and a half day of hands-on lab work. Following the educational program, repair costs dropped 84 percent, to $8 per procedure. The average yearly cost of implementing the program was $3,000 per year, which included textbook costs, meals and refreshments, and travel honoraria for speakers from other institutions. An educational program that includes equipment training can greatly reduce repair costs. The study appears in the April issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.
Treating GERD May Not Improve Asthma Control
Treating patients with difficult-to-control asthma for gastroesophageal reflux disease (GERD) will not improve their asthma management outcome, according to a new study. Researchers from Regional Respiratory Centre, Belfast City Hospital and Esophageal Laboratory, Belfast, United Kingdom, performed 24-hour, dual-probe pH monitoring on 68 patients with difficult asthma, 34 of whom were classified as therapy-responsive and 34 of whom were therapy-resistant to GERD therapy. The results show that 75 percent of patients had GERD/GERD-associated asthma symptoms and 55 percent were found to have GERD, as measured by an abnormal pH profile. Findings show that the therapy-responsive and therapy-resistant patients with asthma had a similar prevalence of GERD and, of the patients who were identified as having GERD, their asthma outcomes did not improve as a result of GERD therapy. The study's results challenge the existing notion that treating patients with asthma for GERD will improve their symptoms, and raise the possibility that asthma and GERD may be two common conditions in the same patients. The study appears in the April issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.