Lower Respiratory Tract Infection (LRTI) Respiratory Unspecified acute lower respiratory infection
Conditions
Interventions
All patients receive guideline-based, multidisciplinary bundle of clinical, laboratory (PCT), nursing, functional and psychosocial care, enforced with high-intensity and include clinical (CURB65 and m
Sponsors
Kantonsspital Aarau (Switzerland)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Patients 18 years of age or older 2. Admitted from the community or a nursing home with acute (i.e. symptoms less than 28 days) Lower Respiratory Tract Infection (LRTI) as main diagnosis. LRTI will consist of at least one respiratory symptom (cough, sputum production, dyspnea, tachypnea, pleuritic pain) and one auscultatory finding or systemic inflammatory signs (core body temperature >38.0° C, shivers, leukocyte count >10 or <4 x 109 cells/ L) independent of antibiotic pretreatment. 3. Ability to understand verbal and written instructions and informed consent by patient or available relatives
Exclusion criteria
Exclusion criteria: 1. Patients permanently unable to give written informed consent, e.g. with severe dementia, if no relative and an independent physician (not part of the study team) are available to provide consent for the patient 2. Patients without command of the German, English, French, Italian, Turkish or Serbian language, who will not be able, within reason, to get translators (e.g. family members) during admission, hospitalization and follow-up telephone interview 3. Terminal and very severe disease or medical co-morbidity where death is imminent and comfort therapy is provided 4. Severe immunosuppression, foreseeable non-compliance for follow-up (e.g. current drug use)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Physician-led length of stay during the index hospital exposure | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Primary Aim: 1.1. Other measures of resource utilization (different definitions of length of stay including rehospitalisation; treatment changes) 1.2. Adherence to triage algorithms 1.3. Functional status and adverse events (i.e. mortality; rate of complications) 1.4. Patient satisfaction 1.5. Quality of life assessment 1.6. Effective and chargeable costs for treatment path. Endpoints will be assessed at discharge to non-hospital setting, 30 days and 3 months after admission. 2. Secondary aim: 2.1. Evaluation of the feasibility of an NLU on institutional, patient and nurse outcomes using a mixed methods approach | — |
Countries
Switzerland
Outcome results
None listed