Fulfilment assessment of the good clinical practices guidelines for community acquired pneumonia. Evaluación del cumplimiento de la guía de práctica clínica para el tratamiento de la neumonía adquirida en la comunidad.

Background: Community acquired pneumonia is the most common cause of infections found during the medical practice. Objective: To assess the fulfilment of the good clinical practices guidelines for the treatment of community acquired pneumonia. Methods: Prospective, descriptive study of series of cases developed in the Hospital “Dr. Gustavo Aldereguía Lima” between January, 1st and June 30th, 2006. 500 patients were studied which main diagnosis was pneumonia or bronchial pneumonia. The assessment tool includes four questions. A single-varied analysis was performed, with a confidence interval of 95%. The final result of this measurement was the fulfilment of the guidelines as excellent, fine, acceptable and not well, as well as the outcome in living and dead patients. Results: Patients older than 65 years of age are the most affected by this disease and fatality is also higher in this age group; 40, 6% of admitted patients are classified as type III. Not performing thoracic radiography and inappropriate treatment led to a higher lethality risk. 53, 2 % of the clinical histories reflects a bad fulfillment of the guide, likewise the biggest lethality was found in that group (36,8 percent). Conclusions: The patients with pneumonias non serious are those that more are admitted in the center, with a non negligible lethality, although the highest was found in the classes IV and V of pnemonia, that were considered the most serious pneumonias. The global adherence to the guide can be related with the final outcome of the patient. Fundamento: La neumonía adquirida en la comunidad es la causa más común de infecciones encontradas en la práctica médica. Objetivo: Evaluar el cumplimiento de la guía de práctica clínica para el tratamiento de la neumonía adquirida en la comunidad. Métodos: Estudio descriptivo, prospectivo, de serie de casos realizado en el Hospital “Dr. Gustavo Aldereguía Lima” desde el 1 de enero al 30 de junio del 2006, sobre 500 pacientes con diagnóstico principal al ingreso y egreso de neumonía o bronconeumonía. Se aplicó el instrumento de evaluación vigente en el centro. Se realizó un análisis univariado, con un intervalo de confianza de 95 por ciento. Se midió el cumplimiento de las guías en excelente, bien, regular y mal, así como el desenlace en vivos y fallecidos. Resultados: Los mayores de 65 a os son los que más ingresan por esta causa y en ellos es más alta la letalidad; el 40, 6 % de los pacientes que ingresan se estratifican en la clase III. La no realización de la radiografía de tórax y el tratamiento inadecuado constituyeron mayor