BACKGROUND The goals of the study were to assess the relationship between age and processes of care in emergency department (ED) patients admitted with pneumonia and to identify independent predictors of failure to meet recommended quality care measures. METHODS This was a prospective cohort study of a pre-existing database undertaken at a university hospital ED in the Midwest. ED patients > or =18 years of age requiring admission for pneumonia, with no documented use of antibiotics in the 24 hours prior to ED presentation were included. Compliance with Pneumonia National Quality Measures was assessed including ED antibiotic administration, antibiotics within 4 hours, oxygenation assessment, and obtaining of blood cultures. Odds ratios were calculated for elders and non-elders. Logistic regression was used to identify independent predictors of process failure. RESULTS One thousand, three hundred seventy patients met inclusion criteria, of which 560 were aged > or =65 years. In multiple variable logistic regression analysis, age > or =65 years was independently associated with receiving antibiotics in the ED (odds ratio [OR] = 2.03, 95% CI 1.28-3.21) and assessment of oxygenation (OR = 2.10, 95% CI, 1.18-3.32). Age had no significant impact on odds of receiving antibiotics within four hours of presentation (OR 1.10, 95% CI 0.84-1.43) or having blood cultures drawn (OR 1.02, 95%CI 0.78-1.32). Certain other patient characteristics were also independently associated with process failure. CONCLUSION Elderly patients admitted from the ED with pneumonia are more likely to receive antibiotics while in the ED and to have oxygenation assessed in the ED than younger patients. The independent association of certain patient characteristics with process failure provides an opportunity to further increase compliance with recommended quality measures in admitted patients diagnosed with pneumonia.

中文翻译：

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老年急诊肺炎患者的护理质量：一项前瞻性队列研究。

背景 本研究的目的是评估年龄与因肺炎入院的急诊科 (ED) 患者的护理过程之间的关系，并确定未能达到推荐的优质护理措施的独立预测因素。方法 这是对在中西部一所大学医院 ED 进行的预先存在的数据库的前瞻性队列研究。ED 患者 > 或 = 18 岁需要因肺炎入院，在 ED 就诊前 24 小时内没有记录使用抗生素的患者被包括在内。对肺炎国家质量措施的依从性进行了评估，包括 ED 抗生素给药、4 小时内抗生素、氧合评估和获得血培养。计算长者和非长者的比值比。Logistic 回归用于识别过程失败的独立预测因素。结果 一千三百七十名患者符合纳入标准，其中 560 名年龄≥65 岁。在多变量逻辑回归分析中，年龄 > 或 = 65 岁与在急诊室接受抗生素（比值比 [OR] = 2.03，95% CI 1.28-3.21）和氧合评估（OR = 2.10，95% CI）独立相关, 1.18-3.32)。年龄对就诊后 4 小时内接受抗生素治疗 (OR 1.10, 95% CI 0.84-1.43) 或进行血培养 (OR 1.02, 95% CI 0.78-1.32) 的几率没有显着影响。某些其他患者特征也与过程失败独立相关。结论 与年轻患者相比，从急诊部收治的肺炎老年患者在急诊室接受抗生素治疗和在急诊室进行氧合评估的可能性更大。某些患者特征与过程失败的独立关联提供了一个机会，可以进一步提高诊断为肺炎的入院患者对推荐质量措施的依从性。