An Early Screening Tool for Discharge Planning Shortened Length of Hospital Stay for Elderly Patients with Community-Acquired Pneumonia

Figures & data

Figure 1 Checklist of risk factors for delayed discharge.

Note: Early discharge planning performed if 3 or more minor items from major items 1 to 6 were applicable, or even 1 minor item from major items 7 to 8.

Abbreviation: ADL, activities of daily living.

Figure 2 Flowchart of the study.

Abbreviations: HCAP, healthcare-associated pneumonia; HAP, hospital-acquired pneumonia; CAP, community-acquired pneumonia.

Table 1 Population Demographics, Characteristics, and Outcomes of the Two Groups

	Total	Usual Group	Screening Group
	n=648	n=325	n=323	p-value
Age (y)	76 (68–83)	79 (71–84)	73 (66–81)	<0.001
Male/Female	433/215	1113/212	102/221	0.389
BMI	19.3 (16.6–22.3)	18.7 (16.5–22.1)	19.6 (16.9–22.4)	0.220
Dementia	71 (11.0%)	41 (6.3%)	30 (4.6%)	0.175
Bedsore	16 (2.5%)	6 (0.9%)	10 (1.5%)	0.305
Aspiration	135 (20.8%)	38 (5.9%)	97 (15.0%)	<0.001
CCI score				<0.001
≤1	198 (30.6%)	135 (41.5%)	63 (19.5%)
2	191 (29.5%)	100 (30.8%)	91 (28.2%)
≥3	259 (40.0%)	90 (27.7%)	169 (52.3%)
PSI category				<0.001
II	57 (8.8%)	38 (11.7%)	19 (5.9%)
III	128 (19.8%)	107 (32.9%)	21 (6.5%)
IV	259 (40.0%)	143 (44.0%)	116 (35.9%)
V	204 (31.5%)	37 (11.4%)	167 (51.7%)
DOAT	9 (7–12)	8 (7–12)	9 (7–13)	0.135
LOS	15 (9–24)	16 (10–27.5)	13 (9–22)	<0.001
Survived				0.011
At home	381 (63.9%)	198 (64.3%)	183 (63.5%)
Nursing home	121 (22.3%)	74 (24.0)	47 (16.3%)
Facility	50 (8.4%)	19 (6.2%)	31 (10.8%)
Hospital	44 (7.4%)	17 (5.5%)	27 (9.4%)
In-hospital mortality	52 (8.0%)	17 (5.2%)	35 (10.8)	0.009
Key person				<0.001
Children	250 (38.6%)	167 (51.4%)	83 (25.8%)
Spouse	324 (50.1%)	127 (39.1%)	197 (61.2%)
Others	73 (11.3%)	31 (9.5%)	42 (13.0%)

Abbreviations: BMI, body mass index; CCI, Charlson Comorbidity Index; DOAT, duration of antibiotic treatment; LOS, length of stay; PSI, Pneumonia Severity Index.

Table 2 Matched Pairs in the Two Groups

	Usual Group	Screening Group	p-value	Std-Diff
	n=118	n=118
Age (y)	79 (70–83)	76.5 (67–84)	0.268	0.145
Male/Female	87/31	75/43	0.092	0.219
Aspiration	24 (20.3%)	25 (21.2%)	0.873	0.021
CCI			0.161
≤1	42 (35.6%)	45 (38.1%)		0.052
2	27 (22.9%)	37 (31.4%)		0.192
≥3	49 (41.5%)	36 (30.5%)		0.231
PSI score			0.175
II	6 (5.1%)	12 (10.2%)		0.193
III	14 (11.9%)	17 (14.4%)		0.074
IV	66 (55.9%)	53 (44.9%)		0.221
V	32 (27.1%)	36 (30.5%)		0.075
Key person			0.971
Children	46 (39.0%)	47 (39.8%)		0.016
Spouse	61 (51.7%)	61 (51.7%)		0
Others	11 (9.3%)	10 (8.5%)		0.028
LOAT (day)	9 (7–14)	9 (6–12)	0.744	0.043
LOS (day)	19.5 (11–32)	13 (8–22)	<0.001	0.410
Survived			0.011
At home	62 (57.4%)	69 (63.9%)		0.133
Nursing home	35 (32.4%)	17 (15.7%)		0.398
Facility	4 (3.7%)	12 (11.1%)		0.286
Hospital	7 (6.5%)	10 (9.3%)		0.104
In-hospital mortality	10 (8.5%)	10 (8.5%)	1.000	0
Readmission	10 (8.5%)	9 (7.6%)	0.811	0.033
Early discharge	Not applicable	77 (65.2%)
Cost ($)	5476 (3830–8299)	4985 (3542–7295)	0.035	0.282

Abbreviations: CCI, Charlson Comorbidity Index; LOAT, length of antibiotic treatment; LOS, length of stay; PSI, Pneumonia Severity Index; std-diff, standardized difference.

Table 3 Details of Waiting Time After Antibacterial Treatment for Different Discharge Destinations

	Usual Group	Screening Group	p value
Home (day)	8 (3–15)	2 (1–5)	<0.001
Nursing home (day)	9 (2–17)	4 (2–10)	<0.001
Facility (day)	30 (7–23)	9 (1–23)	<0.001
Hospital (day)	35 (12–59)	11 (2–24)	<0.001
Overall (day)	9 (2–17)	2 (1–9)	<0.001