Chen Liang, Zhou Fei, Li Hui, Xing Xiqian, Han Xiudi, Wang Yiming, Zhang Chunxiao, Suo Lijun, Wang Jingxiang, Yu Guohua, Wang Guangqiang, Yao Xuexin, Yu Hongxia, Wang Lei, Liu Meng, Xue Chunxue, Liu Bo, Zhu Xiaoli, Li Yanli, Xiao Ying, Cui Xiaojing, Li Lijuan, Uyeki Timothy M, Wang Chen, Cao Bin
Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Department of Infectious Disease, 4th Medical College of Peking University, Beijing Jishuitan Hospital, Beijing, China.
BMJ Open. 2018 Feb 15;8(2):e018709. doi: 10.1136/bmjopen-2017-018709.
To describe the clinical characteristics and management of patients hospitalised with community-acquired pneumonia (CAP) in China.
This was a multicentre, retrospective, observational study.
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.
Resource use for CAP management.
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%.
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.
NCT02489578; Results.
描述中国社区获得性肺炎（CAP）住院患者的临床特征及管理情况。
这是一项多中心、回顾性观察研究。
2014年1月1日至2014年12月31日期间，中国北方、中部和南部的13家教学医院。
使用标准病例报告表收集年龄≥14岁、影像学确诊为社区发病肺炎的住院患者信息。
CAP管理的资源使用情况。
在筛查的14793例患者中，5828例影像学确诊为CAP的患者纳入最终分析。CURB-65评分0-1分的低死亡风险患者和肺炎严重程度指数风险等级I-II级的患者分别占81.2%（4434/5594）和56.4%（2034/3609）。21.7%（1111/5130）的患者入院时已达到临床稳定。仅在12.7%（738/5828）的患者中确定了明确或可能的病原体。40.9%（1575/3852）无假单胞菌感染风险因素的患者接受了抗菌药物过度治疗方案。从临床稳定到出院的中位时间为5.0天，30天死亡率为4.2%。
这些数据表明CAP管理中卫生资源的过度使用，表明中国医疗系统有改善的潜力和可观的节省空间。
NCT02489578；结果。
