Department of Respiratory Medicine, Royal Perth Hospital, Perth, WA, Australia.
Respirology. 2018 Feb;23(2):138-147. doi: 10.1111/resp.13218. Epub 2017 Nov 17.
Community-acquired pneumonia (CAP) is a common acute medical illness with a standard, effective treatment that was introduced before the evidenced-based medicine era. Mortality rates have improved in recent decades but improvements have been minimal when compared to other conditions such as acute coronary syndromes. The standardized approach to treatment makes CAP a target for comparative performance and outcome measures. While easy to collect, simplistic outcomes such as mortality, readmission and length of stay are difficult to interpret as they can be affected by subjective choices and health care resources. Proposed clinical- and patient-reported outcomes are discussed below and include measures such as the time to clinical stability (TTCS) and patient satisfaction, which can be compared between health institutions. Strategies to improve these outcomes include use of a risk stratification tool, local antimicrobial guidelines with antibiotic stewardship and care bundles to include early administration of antibiotics and early mobilization.
社区获得性肺炎（CAP）是一种常见的急性内科疾病，有标准且有效的治疗方法，该方法在循证医学时代之前就已被提出。尽管近几十年来死亡率有所改善，但与急性冠状动脉综合征等其他疾病相比，改善幅度很小。这种标准化的治疗方法使得 CAP 成为比较绩效和结果衡量的目标。虽然易于收集，但死亡率、再入院率和住院时间等简单的结果很难解释，因为它们可能受到主观选择和医疗资源的影响。下面讨论了拟议的临床和患者报告的结果，包括临床稳定时间（TTCS）和患者满意度等措施，这些措施可以在医疗机构之间进行比较。改善这些结果的策略包括使用风险分层工具、具有抗生素管理的本地抗菌药物指南以及包括早期使用抗生素和早期活动的护理包。
