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肺部超声联合C反应蛋白即时检测对下呼吸道感染患者常规医疗中临床决策及感知有用性的影响:分析性观察研究方案

Impact of Lung Ultrasound along with C-Reactive Protein Point-of-Care Testing on Clinical Decision-Making and Perceived Usefulness in Routine Healthcare for Patients with Lower Respiratory Tract Infections: Protocol for Analytical Observational Study.

作者信息

Llinas Anna, Paredes Eugeni, Sol Joaquim, Palacin Jose Maria, Solanes Monica, Martinez Javier, Florensa Carme, Llort Laia, Castañ Maria Teresa, Gracia Maria Isabel, Paül Josep Miquel, Ortega Bravo Marta, Llor Carl

机构信息

Onze de Setembre Primary Care Centre, Institut Català de la Salut, 25005 Lleida, Spain.

GRECOCAP Research Group, University Institute in Primary Care Research Jordi Gol, 08007 Barcelona, Spain.

出版信息

J Clin Med. 2024 Sep 27;13(19):5770. doi: 10.3390/jcm13195770.

Abstract

: Lower respiratory tract infections (LRTIs) are a significant cause of primary care consultations. Differentiating between viral and bacterial infections is critical for effective treatment and to minimize unnecessary antibiotic use. This study investigates the impact of combining lung ultrasound (LUS) with capillary blood C-reactive protein (CRP) rapid testing on clinical decision-making for patients with LRTIs. : The primary objective is to assess how the integration of CRP testing and LUS influences antibiotic prescription decisions. The study aims to quantify the percentage change in antibiotic prescriptions before and after performing LUS, following history taking, clinical examination, and CRP testing. : This analytical observational study will be conducted in six primary care centers within the Health Region of Lleida, Catalonia, serving a mixed urban and rural population of approximately 105,000 residents. The study will recruit 196 patients aged 18 and over, presenting with LRTI symptoms and not treated with antibiotics in the preceding 14 days. Participants will undergo CRP testing followed by LUS during their consultation. Statistical analyses, including linear regression, bivariate analysis, Pearson or Spearman correlation, and logistic regression, will be used to evaluate the impact of LUS on clinical decisions and its predictive value in diagnosing bacterial infections. : This study will provide insights into the role of LUS combined with CRP testing in improving diagnostic accuracy and guiding antibiotic prescription decisions in primary care. The findings aim to enhance treatment protocols for LRTIs, reducing unnecessary antibiotic use and improving patient outcomes.

摘要

下呼吸道感染(LRTIs)是基层医疗会诊的一个重要原因。区分病毒感染和细菌感染对于有效治疗以及尽量减少不必要的抗生素使用至关重要。本研究调查了将肺部超声(LUS)与毛细血管血C反应蛋白(CRP)快速检测相结合对LRTIs患者临床决策的影响。:主要目的是评估CRP检测和LUS的整合如何影响抗生素处方决策。该研究旨在量化在进行病史采集、临床检查和CRP检测后,进行LUS前后抗生素处方的百分比变化。:这项分析性观察研究将在加泰罗尼亚莱里达健康区的六个基层医疗中心进行,服务于约105,000名城乡混合居民。该研究将招募196名18岁及以上的患者,这些患者出现LRTI症状且在过去14天内未接受过抗生素治疗。参与者在会诊期间将先进行CRP检测,然后进行LUS。统计分析,包括线性回归、双变量分析、Pearson或Spearman相关性分析以及逻辑回归,将用于评估LUS对临床决策的影响及其在诊断细菌感染中的预测价值。:本研究将深入了解LUS与CRP检测相结合在提高基层医疗诊断准确性和指导抗生素处方决策方面的作用。研究结果旨在改进LRTIs的治疗方案,减少不必要的抗生素使用并改善患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c10/11476663/7841176a24e2/jcm-13-05770-g001.jpg

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