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在埃塞俄比亚东部哈拉尔的公立医院中,肺炎患者的治疗结果及其相关因素:一项回顾性随访研究。

Treatment outcomes and its associated factors among pneumonia patients admitted to public hospitals in Harar, eastern Ethiopia: a retrospective follow-up study.

机构信息

Clinical Pharmacy Department, Haramaya University, Dire Dawa, Ethiopia

Department of Pharmacology and Toxicology, Haramaya University, Dire Dawa, Ethiopia.

出版信息

BMJ Open. 2023 Feb 15;13(2):e065071. doi: 10.1136/bmjopen-2022-065071.

Abstract

OBJECTIVE

Although there is a high risk of drug resistance, empiric treatment is a common approach for pneumonia management. In this respect, it is relevant to know treatment outcomes of patients with pneumonia. This study aimed to assess treatment outcomes and its associated factors among pneumonia patients treated at two public hospitals in Harar, eastern Ethiopia.

DESIGN

Retrospective follow-up study.

SETTING

Jugal General Hospital and Hiwot Fana Specialised University Hospital in Harar, eastern Ethiopia.

PARTICIPANTS

Patients admitted and treated for pneumonia in the two public hospitals in eastern Ethiopia between April 2020 and April 2021.

PRIMARY OUTCOME

The primary outcome was unfavourable treatment outcome (died or transferred to intensive care unit) for pneumonia patients.

RESULTS

A total of 693 patients with pneumonia were included in the study. 88 (12.7%) of these patients had an unfavourable treatment outcome, which included 14 (2%) transfers to the intensive care unit and 74 (10.7%) deaths. Patients with comorbidity (adjusted OR, AOR=2.96; 95% CI: 1.47 to 5.97) and with clinical features including abnormal body temperature (AOR=4.03; 95% CI: 2.14 to 7.58), tachycardia (AOR=2.57; 95% CI: 1.45 to 4.55), bradypnoea or tachypnoea (AOR=3.92; 95% CI:1.94 to 7.92), oxygen saturation below 90% (AOR=2.52; 95% CI:1.37 to 4.64) and leucocytosis (AOR=2.78, 95%, CI:1.38 to 5.58) had a significantly increased unfavourable treatment outcome.

CONCLUSION

We found that nearly one out of eight patients with pneumonia had unfavourable treatment outcomes. It was considerably high among patients with comorbidities and apparent abnormal clinical conditions. Therefore, taking into account regionally adaptable intervention and paying close attention to pneumonia patients admitted with comorbidity and other superimposed abnormal conditions might help improve the treatment outcomes of these populations.

摘要

目的

尽管存在耐药风险,但经验性治疗仍是肺炎管理的常见方法。在这方面,了解肺炎患者的治疗结果是很重要的。本研究旨在评估在埃塞俄比亚东部哈拉尔的两家公立医院接受治疗的肺炎患者的治疗结果及其相关因素。

设计

回顾性随访研究。

地点

哈拉尔的朱加尔综合医院和 Hiwot Fana 专科医院。

参与者

2020 年 4 月至 2021 年 4 月期间在埃塞俄比亚东部这两家公立医院因肺炎住院和接受治疗的患者。

主要结局

肺炎患者的不良治疗结局(死亡或转至重症监护病房)。

结果

共有 693 名肺炎患者纳入研究。其中 88 名(12.7%)患者的治疗结果不佳,包括 14 名(2%)转至重症监护病房和 74 名(10.7%)死亡。患有合并症的患者(调整后的比值比,OR=2.96;95%CI:1.47 至 5.97)和具有以下临床特征的患者:体温异常(OR=4.03;95%CI:2.14 至 7.58)、心动过速(OR=2.57;95%CI:1.45 至 4.55)、呼吸过缓或呼吸过速(OR=3.92;95%CI:1.94 至 7.92)、血氧饱和度低于 90%(OR=2.52;95%CI:1.37 至 4.64)和白细胞增多(OR=2.78,95%CI:1.38 至 5.58),其不良治疗结局的风险显著增加。

结论

我们发现,近八分之一的肺炎患者治疗结果不佳。在患有合并症和明显异常临床状况的患者中,这一比例相当高。因此,考虑到区域适应性干预措施,并密切关注因合并症和其他合并异常情况而入院的肺炎患者,可能有助于改善这些人群的治疗结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e086/9933768/fd007ce3e357/bmjopen-2022-065071f01.jpg

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