Pulmonary severity score at admittance: Selection of site of care

Severity score systems can support rapid,correct selection of patient routes after hospital admittance. No score system has been available for emergency respiratory conditions though it is important to quickly decide whether such patients are admitted to non-invasive respiratory unit (NIRU) or open pulmonary ward. Therefore, we have formed a score system and tested it on 62 patients who underwent emergency, non-oncological pulmonary admission in October 2015 at our Department. Scores were higher if patient had tachypnoe, tachycardia, hypo- or hypertension, O2 saturation, known severe non-respiratory disease, high or low body mass index, age>60 ys, acidosis, hypercapnia, bilateral pneumonia, severe interstitial lung disease or advanced chronic obstructive pulmonary disease. If patient had a score higher than 9 was considered as high risk and admitted to NIRU. Thirteen out of 62 patients (21%) needed admittance at NIRU. Other patients with scores <8 were placed at open pulmonary ward. Those patients with intermediate scores of 7-8, duration of hospital care was 16.0±2.3 days (n=7 ) which was longer than duration of care of those who had a score of 6 or less (8.5±0.9, n=43, p=0.005). Intermediate score (7-8) patients admitted to open pulmonary ward needed longer duration of care than more severe patients (>9) but admitted at NIRU (12.5±1.3, p=0.18). Intermediate score patients not taken to NIRU may have longer duration of hospital stay than more sev...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: 2.2 Noninvasive Ventilatory Support Source Type: research