Outpatient therapy best for some pneumonia patients

NEW YORK (Reuters Health) - Many low-risk patients with community-acquired pneumonia recover faster and do not have an increased mortality risk if they are treated as outpatients rather than inpatients, findings from a new study show.

Current treatment guidelines recommend that low-risk patients, based on the pneumonia severity index score, be treated as outpatients, yet many physicians continue to hospitalize these patients, Dr. Michael J. Fine, from the Veterans Affairs Pittsburgh Healthcare System, and colleagues note in the medical journal Chest.

In their study, Fine and colleagues compared the outcomes of low-risk pneumonia patients treated as outpatients (944 subjects) or as inpatients (569 subjects).

Outpatients were 2.0-times more likely than inpatients to return to work within 30 days of treatment, the researchers report, and 1.4-times more likely to resume usual activities within that period.

The overall 30-day mortality rate was 0.1 percent for the outpatients and 2.6 percent for inpatients. However, after adjusting the data for factors that could influence patient outcome and comparing patients with similar characteristics within the two groups, the difference in mortality between the outpatients and the inpatients was not statistically significant.

Although there was no difference in mortality between based on treatment site, "the increased risk of overall mortality for all low-risk patients in this study emphasizes the importance of physician judgment" in addition to the use of objective information in deciding were patients with pneumonia will be treated.

SOURCE: Chest: February 2007.