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- Title
Guideline-Recommended Management of Community-Acquired Pneumonia in Veterans With Spinal Cord Injury.
- Authors
Evans, Charlesnika T.; Weaver, Frances M.; Rogers, Thea J.; Rapacki, Lauren; Miskevics, Scott; Hahm, Bridge; Smith, Bridge; Lavela, Sherri L.; Goldstein, Barry; Burns, Stephen P.
- Abstract
Background: Pneumonia is a leading cause of death in persons with spinal cord injuries and disorders (SCI/D), but little is known about guideline-based management for this disease in persons with SCI/D. Objectives: The goal of this study was to describe guideline-based medical care for community-acquired pneumonia (CAP) in veterans with SCI/D. Methods: A retrospective medical record review was conducted at 7 Department of Veterans Affairs (VA) medical centers where veterans with SCI/D and CAP between 2005 and 2008 were included. Outcomes assessed were receipt of blood or sputum culture, antibiotic timeliness, appropriateness of empiric antibiotic treatment, and vaccination. Results: In 70 patients, 77 CAP episodes occurred and 83.1% were treated in the inpatient setting. The average age was 70.0 years and 64.9% had tetraplegia. Sputum culture was completed in 24.7% and blood culture in 59.7% of cases. Of inpatients, 79.7% had antibiotic treatment within 8 hours and 45.1% received guideline-recommended empirical antibiotics. More than 90% of inpatients received antibiotic treatment within 3 days of presentation and 78.1% received recommended treatment. The rates of pneumococcal pneumonia (89.9%) and influenza (79.7%) vaccinations were high in CAP cases. Conclusions: Diagnostic testing and early guideline-recommended treatment is variable in veterans with SCI/D and CAP. However vaccination against influenza and pneumococcal pneumonia is high. Specific guidelines for management of CAP in SCI/D patients may be needed, which reflect the unique risk factors and needs of this population. These data can be used as a benchmark for improvements in care processes for treating and managing CAP in persons with SCI/D.
- Subjects
ANTIBIOTICS; COMMUNITY-acquired pneumonia; FISHER exact test; IMMUNIZATION; VETERANS; PARAPLEGIA; RESEARCH funding; SPINAL cord injuries; DISEASE management; RETROSPECTIVE studies; DATA analysis software; DESCRIPTIVE statistics; PREVENTION; DIAGNOSIS
- Publication
Topics in Spinal Cord Injury Rehabilitation, 2012, Vol 18, Issue 4, p300
- ISSN
1082-0744
- Publication type
Article
- DOI
10.1310/sci1804-300