Standardized Emergency Care for Community Acquired Pneumonia (CAP)

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Prof. Dr. Michael Christ, Klinikum Nürnberg
ClinicalTrials.gov Identifier:
NCT01963000
First received: October 10, 2013
Last updated: October 15, 2013
Last verified: October 2013
  Purpose

Community acquired pneumonia (CAP) is associated with a high in-hospital mortality. Standardization of diagnostics and adherence to sepsis bundles in the emergency department (ED) are associated with reduced mortality in patients with sepsis. Investigators examined whether the introduction of standardized care bundles and check lists in the ED are associated with a reduced mortality rate in patients hospitalized for CAP.

This is an observational trial. The investigators retrospectively analyzed performance indicators of 2819 consecutive patients with CAP admitted to the Nuremberg Hospital, Germany, from 2008 to 2009. At the turn of the year, implementation of CAP care bundles took place including interprofessional education, checklists and institutionalized feedback. Primary endpoint was in-hospital mortality of CAP patients. After the implementation of CAP care bundles in the ED, mortality of affected patients was significantly lower in 2009 compared to 2008. This study should demonstrate that the implementation of a standardized CAP care bundle in the ED is associated with a risk reduction in affected patients. Standardization of diagnostic and therapeutic processes in the ED therefore improves the outcome of patients hospitalized for CAP.


Condition
Community Acquired Pneumonia
Pneumonia
Infection

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Retrospective
Official Title: Reduction of Mortality in Community-Acquired Pneumonia After Implementing Standardized Care Bundles in the Emergency Department

Resource links provided by NLM:


Further study details as provided by Klinikum Nürnberg:

Primary Outcome Measures:
  • mortality of CAP patients [ Time Frame: up to 14days ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • mortality up to 14days in subgroups [ Time Frame: up to 14 days ] [ Designated as safety issue: No ]

    Mortality of patients upt to 14day is determined in subgroups (different age groups, sub-groups of CRB-risk classes)

    CRB-65: C mental confusion; R respiratory rate ≥30/min; B systolic blood pressure <90 mm Hg; 65, age ≥65 years



Enrollment: 2819
Study Start Date: January 2007
Study Completion Date: December 2012
Primary Completion Date: December 2012 (Final data collection date for primary outcome measure)
Groups/Cohorts
CAP
A patient with CAP was identified by encoding pneumonia without severe immunosuppression (HIV infection, solid organ or bone marrow/stem cell transplants, severe neutropenia) as the main diagnosis (ICD 10 GM) of hospital admission.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population

Emergency department patients

Criteria

Inclusion Criteria:

  • all patients with community acquired pneumonia

Exclusion Criteria:

  • exacerbation of chronic obstructive pulmonary disease
  • malignancy
  • immunosuppression
  • neutropenia
  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT01963000

Locations
Germany
City Hospital Nuremberg
Nuremberg, Bavaria, Germany, 90419
Sponsors and Collaborators
Klinikum Nürnberg
  More Information

No publications provided

Responsible Party: Prof. Dr. Michael Christ, Prof. Dr. med. Michael Christ, Klinikum Nürnberg
ClinicalTrials.gov Identifier: NCT01963000     History of Changes
Other Study ID Numbers: CAP01ED
Study First Received: October 10, 2013
Last Updated: October 15, 2013
Health Authority: Germany: Ethics Commission

Keywords provided by Klinikum Nürnberg:
Community Acquired Pneumonia
Emergency Department
Standardized Care
Reduced Mortality
CRB-65 Risk Classes
Antibiotic Therapy

Additional relevant MeSH terms:
Emergencies
Pneumonia
Disease Attributes
Pathologic Processes
Lung Diseases
Respiratory Tract Diseases
Respiratory Tract Infections

ClinicalTrials.gov processed this record on August 28, 2014