Presentations to EDs in Alberta, Canada, for pneumonia: a large population-based study

Chest. 2010 Dec;138(6):1363-70. doi: 10.1378/chest.09-2829. Epub 2010 May 14.

Abstract

Background: Pneumonia is an infection of the lung and a common presentation problem in EDs. The objective of this study was to describe the epidemiology of pneumonia presentations to EDs in the province of Alberta, Canada.

Methods: Provincial administrative databases were used to obtain all ED encounters for pneumonia during 6 fiscal years (April 1999 to March 2005). Information extracted included demographics, ED visit timing, and subsequent visits to non-ED settings. Data analysis included descriptive summaries and directly standardized visit rates.

Results: A total of 190,896 ED visits for pneumonia were made by 140,913 distinct individuals (average of 1.4 visits per individual). Most (80.6%) had only one pneumonia-related ED visit. Male patients presented in slightly higher numbers than female patients. Standardized visit rates decreased overall from 12.5/1,000 population in 1999-2000 to 9.1/1,000 in 2004-2005. Admission occurred in 28.2% of the cases. In a discharged subset, 4.8% had a repeat ED visit within 7 days. Overall, 67.0% of individuals had yet to have a non-ED follow-up visit by 1 week; the estimated median time to the first follow-up visit was 21 days (95% CI, 20-22).

Conclusions: Pneumonia is a common presenting problem in Alberta EDs, and further study is required to understand the factors associated with the variation in presentations. Findings include a decrease in presentations after the first fiscal year, disparities based on age, sex, and socioeconomic/cultural status, and a low rate of early follow-up.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Alberta / epidemiology
  • Canada / epidemiology
  • Child
  • Child, Preschool
  • Cohort Studies
  • Confidence Intervals
  • Databases, Factual
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Length of Stay
  • Male
  • Middle Aged
  • Patient Discharge / statistics & numerical data
  • Pneumonia / diagnosis*
  • Pneumonia / epidemiology*
  • Pneumonia / therapy
  • Prognosis
  • Sex Distribution
  • Statistics, Nonparametric
  • Young Adult