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社区获得性肺炎在因呼吸疾病就诊急诊后的诊断。

Community-Acquired Pneumonia Diagnosis Following Emergency Department Visits for Respiratory Illness.

机构信息

Department of Pediatrics, Harvard Medical School, Boston, MA, USA.

Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA.

出版信息

Clin Pediatr (Phila). 2025 Jan;64(1):83-90. doi: 10.1177/00099228241254153. Epub 2024 May 17.

Abstract

Community-acquired pneumonia (CAP) is often considered for children presenting to the emergency department (ED) with respiratory symptoms. It is unclear how often children are diagnosed with CAP following an ED visit for respiratory illness. We performed a retrospective case-control study to evaluate 7-day CAP diagnosis among children 3 months to 18 years discharged from the ED with respiratory illness from 2011 to 2021 and who receive care at 4 hospital-affiliated primary care clinics. Logistic regression was performed to assess for predictors of 7-day CAP diagnosis. Seventy-four (0.7%, 95% confidence interval [CI] = 0.6%, 0.9%) of 10 329 children were diagnosed with CAP within 7 days, and fever at the index visit was associated with increased odds of diagnosis (odds ratio [OR] = 3.32, 95% CI = 1.75-6.28). Community-acquired pneumonia diagnosis after discharge from the ED with respiratory illness is rare, even among children who are febrile at time of initial evaluation.

摘要

社区获得性肺炎(CAP)常被认为是儿童因呼吸症状就诊于急诊科(ED)的主要原因。但对于 ED 因呼吸疾病就诊的儿童,有多少人在后续被诊断为 CAP,目前尚不清楚。我们进行了一项回顾性病例对照研究,以评估 2011 年至 2021 年间在 ED 因呼吸疾病出院的 3 个月至 18 岁儿童中,在接受 4 家医院附属初级保健诊所治疗后,7 天内 CAP 的诊断情况。采用 logistic 回归分析评估 7 天内 CAP 诊断的预测因素。在 10329 名儿童中,有 74 名(0.7%,95%置信区间 [CI] = 0.6%,0.9%)在 7 天内被诊断为 CAP,而就诊时发热与诊断几率增加相关(比值比 [OR] = 3.32,95% CI = 1.75-6.28)。在 ED 因呼吸疾病出院后,即使是在初始评估时发热的儿童,CAP 的诊断也很少见。

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