Disease characteristics and management of hospitalised adolescents and adults with community-acquired pneumonia in China: a retrospective multicentre survey

被引:44
作者
Chen, Liang [1 ,2 ]
Zhou, Fei [1 ]
Li, Hui [3 ]
Xing, Xiqian [4 ]
Han, Xiudi [5 ]
Wang, Yiming [3 ]
Zhang, Chunxiao [6 ]
Suo, Lijun [7 ]
Wang, Jingxiang [8 ]
Yu, Guohua [9 ]
Wang, Guangqiang [10 ]
Yao, Xuexin [11 ]
Yu, Hongxia [12 ]
Wang, Lei [13 ]
Liu, Meng [1 ]
Xue, Chunxue [1 ]
Liu, Bo [7 ]
Zhu, Xiaoli [14 ]
Li, Yanli [1 ]
Xiao, Ying [1 ]
Cui, Xiaojing
Li, Lijuan
Uyeki, Timothy M. [15 ]
Wang, Chen [3 ,16 ]
Cao, Bin [3 ,16 ]
机构
[1] Capital Med Univ, Beijing Chao Yang Hosp, Dept Infect Dis & Clin Microbiol, Beijing, Peoples R China
[2] Peking Univ, Med Coll 4, Dept Infect Dis, Beijing Jishuitan Hosp, Beijing, Peoples R China
[3] China Japan Friendship Hosp, Dept Pulm & Crit Care Med, Ctr Resp Dis, Natl Clin Res Ctr Resp Dis, Beijing, Peoples R China
[4] Kunming Med Univ, Yanan Hosp, Dept Resp Med, Kunming, Yunnan, Peoples R China
[5] Qingdao Municipal Hosp, Dept Resp Med, Qingdao, Peoples R China
[6] Beijing Huimin Hosp, Dept Resp Med, Beijing, Peoples R China
[7] Linzi Dist Peoples Hosp, Dept Resp Med, Zibo, Peoples R China
[8] Capital Med Univ, Beijing Luhe Hosp, Dept Resp Med, Weifang, Peoples R China
[9] Weifang 2 Peoples Hosp, Dept Pulm & Crit Care Med, Weifang, Peoples R China
[10] Shandong Univ Qindao, Dept Resp Med, Qilu Hosp, Qingdao, Peoples R China
[11] Chinese Armed Police Forces, Hosp Beijing Corps 2, Dept Resp Med, Beijing, Peoples R China
[12] Yantai Yuhuangding Hosp, Dept Infect Dis, Yantai, Peoples R China
[13] Shandong Chinese Med Univ, Rizhao Chinese Med Hosp, Dept Resp Med, Rizhao, Peoples R China
[14] Capital Med Univ, Beijing Chao Yang Hosp, Occupat Med & Toxicol Dept, Beijing, Peoples R China
[15] Ctr Dis Control & Prevent, Influenza Div, Natl Ctr Immunizat & Resp Dis, Atlanta, GA USA
[16] Capital Med Univ, Dept Pulm Med, Beijing, Peoples R China
来源
BMJ OPEN | 2018年 / 8卷 / 02期
关键词
LOW-RISK PATIENTS; MULTIDRUG-RESISTANT PATHOGENS; CARE-ASSOCIATED PNEUMONIA; ORAL ANTIBIOTICS; COST; TUBERCULOSIS; POPULATION; VALIDATION; MORTALITY; SEVERITY;
D O I
10.1136/bmjopen-2017-018709
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives To describe the clinical characteristics and management of patients hospitalised with community-acquired pneumonia (CAP) in China. Design This was a multicentre, retrospective, observational study. Setting 13 teaching hospitals in northern, central and southern China from 1 January 2014 to 31 December 2014 Participants Information on hospitalised patients aged >= 14 years with radiographically confirmed pneumonia with illness onset in the community was collected using standard case report forms. Primary and secondary outcome measures Resource use for CAP management. Results Of 14 793 patients screened, 5828 with radiographically confirmed CAP were included in the final analysis. Low mortality risk patients with a CURB-65 score 0-1 and Pneumonia Severity Index risk class I-II accounted for 81.2% (4434/5594) and 56.4% (2034/3609) patients, respectively. 21.7% (1111/5130) patients had already achieved clinical stability on admission. A definite or probable pathogen was identified only in 12.7% (738/5828) patients. 40.9% (1575/3852) patients without pseudomonal infection risk factors received antimicrobial overtreatment regimens. The median duration between clinical stability to discharge was 5.0 days with 30-day mortality of 4.2%. Conclusions These data demonstrated the overuse of health resources in CAP management, indicating that there is potential for improvement and substantial savings to healthcare systems in China.
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页数:9
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