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Deaths in risk classes I-III: a measure of quality of care in patients hospitalised with CAP?Marrie TJEur Respir J 2004[Jan]; 23 (1): 103-5All deaths occurring in patients with community-acquired pneumonia in risk classes I-III were reviewed as a quality-of-care measure. The immediate and underlying causes of death were classified according to the World Health Organization protocol. Eleven (1.8%) of the 608 low-risk patients died. Three of the patients did not have pneumonia, one of whom was admitted with atypical pulmonary oedema due to stenosis of a prosthetic heart valve. Failure to include chronic lung disease in the severity-of-illness scoring system resulted in misclassification of seven patients. The most common underlying causes of death were pulmonary fibrosis at 27%, chronic obstructive lung disease at 18% and cancer at 27%. Respiratory failure was the immediate cause of death in 64% of patients, cardiac causes in 27%, and pneumonia in 9%. To conclude, the review of deaths in patients at low risk for mortality is useful for monitoring the quality of care received by patients who require admission for the treatment of community-acquired pneumonia, and that the pneumonia-specific severity-of-illness scoring system results in misclassification of patients with chronic obstructive lung disease and pulmonary fibrosis.|*Quality of Health Care[MESH]|Adult[MESH]|Aged[MESH]|Cause of Death[MESH]|Community-Acquired Infections/diagnosis/*mortality[MESH]|Diagnostic Errors[MESH]|Female[MESH]|Heart Diseases/mortality[MESH]|Humans[MESH]|Male[MESH]|Middle Aged[MESH]|Neoplasms/complications[MESH]|Pneumonia/diagnosis/*mortality[MESH]|Pulmonary Disease, Chronic Obstructive/complications[MESH]|Pulmonary Edema/diagnosis/etiology[MESH]|Pulmonary Fibrosis/complications[MESH]|Pulmonary Valve Stenosis/complications[MESH]|Respiratory Insufficiency/mortality[MESH]|Risk Factors[MESH]|Severity of Illness Index[MESH] |
