지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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초록· 키워드
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Objective: In Korea, many hospitals have recently changed the process of internal medicine management in the emergency department (ED) because of reduced manpower, raising concerns regarding the decreased quality of medical care. The process of medical management in the ED was streamlined to resolve the reduced manpower. Thus, this study compared the pneumonia treatment effectiveness before and after the process changes. Methods: This study included patients who were diagnosed with pneumonia in the ED and hospitalized from January 2014 to December 2016. They were divided into two groups based on before and after the changes. The disease severity, management adequacy, and prognosis were compared using the initial quick sequential organ failure assessment score (qSOFA), systemic inflammatory response syndrome criteria (SIRS), CURB-65 score, door-to-antibiotic time (DAT), length of stay (LOS), hospitalization period (HP), and in-hospital mortality, were collected retrospectively from the medical records. Results: The qSOFA, SIRS, and CURB-65 scores did not differ between the two groups. The median (interquartile range) DAT, LOS, and HP were reduced after the process changes: DAT (160.0 minutes [111.0-230.0] vs. 120.0 minutes [74.0-175.0], P<0.001), LOS (7.6 hours [4.8-15.8] vs. 4.7 hours [3.2-6.8], P<0.001), and HP (9.0 days [6.0-16.0] vs. 8.0 days [5.0-15.0], P=0.011). On the other hand, the in-hospital mortality was similar in the two groups (14.1% vs. 11.2%, P=0.162). Conclusion: The DAT, LOS, and HP decreased after the process changes, but the in-hospital mortality did not worsen. This shows that pneumonia management in the ED was not compromised, but rather improved, after the changes.
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참고문헌 (21)
참고문헌 신청
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송재훈 / 2009 / 지역사회획득 폐렴의 치료지침 권고안 / Tuberculosis and Respiratory Diseases 67(4):281~302
신현영 / 2016 / 2014년 사망원인 통계 / 대한의사협회지 59(3):221~232
Annual report on the cause of death statistics 2017 in Korea
Gaieski DF / 2010 / Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department / Crit Care Med 38:1045~1053
송재훈 / 2009 / 지역사회획득 폐렴의 치료지침 권고안 / Tuberculosis and Respiratory Diseases 67(4):281~302
신현영 / 2016 / 2014년 사망원인 통계 / 대한의사협회지 59(3):221~232
Annual report on the cause of death statistics 2017 in Korea
Gaieski DF / 2010 / Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department / Crit Care Med 38:1045~1053
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