Objectives: To assess the safety of discharging patients with community acquired pneumonia (CAP) according to a clinical practice guideline. 

Methods: A systematic retrospective review of medical records of 867 adult patients discharged from an emergency department (ED) with CAP between 3 January 1999 and 3 January 2001. Readmission or death rates within 30 days of discharge were evaluated, using data from all local hospitals and from the provincial coroner. 

Results: Of 685 patients with pneumonia severity index (PSI) scores of ,91, 13 (1.9%) were readmitted and five (0.76%) died within 30 days of the ED visit. Thirty day readmission and death rates for patients with PSI .90 were 7.14% (13 of 182) and 9.34% (17 of 182), respectively. 

Conclusion: Adult patients with CAP discharged from the ED according to the recommendations of a clinical practice guideline based on the PSI have low readmission and death rates, and are generally safely managed as outpatients.

Authors: Sam G. Campbell, Stacy, Ackroyd-Stolarz, Susan Pierce, Rebecca Burton-MacLeod, Dorita Gerami