社区获得性肺炎的紧急计划性再输注治疗与住院治疗：一项回顾性病例对照研究

Emergency planned re-infusion therapy and hospitalisation for community-acquired pneumonia: a retrospective case-control study.

作者信息

Chen Sheng-Xian, Yang Zhi-Kai, Lin Lin, Liao Hou-Zhen, Xiang Xiao-Ting, Liu Di, Huang Jian-Shan

机构信息

Department of Emergency Clinic, Xiamen Chang Gung Hospital, Xiamen, China.

Department of General Medicine, Xiamen Chang Gung Hospital, Xiamen, China.

出版信息

J Glob Health. 2025 Jan 31;15:04044. doi: 10.7189/jogh.15.04044.

DOI:10.7189/jogh.15.04044

PMID:39886894

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11783337/

Abstract

BACKGROUND

Community-acquired pneumonia (CAP) is a frequent reason for emergency department visits and leads to increased direct medical costs, particularly due to hospitalisation. This study aims to examine the differences between emergency planned re-infusion therapy and hospitalisation in patients with CAP.

METHODS

This retrospective case-control study involved 1889 CAP patients treated at the Emergency Internal Medicine Department of Class A tertiary Hospital in China from 1 January 2020 to 31 December 2022. Patients were divided into groups receiving either emergency planned re-infusion therapy or hospitalisation. Independent sample t tests and χ tests were used to compare the clinical outcomes and economic impacts between the two groups across different pneumonia severity index (PSI) classifications.

RESULTS

The study enrolled 1889 CAP patients. For PSI I-II patients, the improvement rates were 99.51% in the emergency planned re-infusion therapy group and 99.69% in the hospitalisation group, showing no statistically significant difference (P > 0.05). Similarly, no significant difference was observed for PSI III patients (84.16 vs. 89.82%). However, significant differences emerged for PSI IV patients, with improvement rates of 50% in the emergency planned re-infusion therapy group and 90.59% in the hospitalisation group (P < 0.001). Statistically significant differences were also noted in treatment duration (5.13 ± 1.65 days vs. 7.60 ± 3.93 days, P < 0.001) and total treatment costs (1921.57 Chinese Yuan (CNY) ± 923.16 vs. 9083.80 CNY ± 3583.55, P < 0.001) between the two groups.

CONCLUSIONS

Emergency planned re-infusion therapy for CAP is an effective and cost-efficient alternative that can reduce both treatment duration and costs, particularly for patients with PSI I-III. It is recommended that emergency physicians give priority to emergency re-infusion therapy for patients with PSI I-III. In addition, it is recommended that hospitals strengthen the classification and treatment training programmes for emergency department physicians to recognise the patients with PSI I-IV.

REGISTRATION

The hospitals ethics committee (XMCGIRB2024034-01).

摘要

背景

社区获得性肺炎（CAP）是急诊科就诊的常见原因，会导致直接医疗费用增加，尤其是住院费用。本研究旨在探讨CAP患者急诊计划性再输注治疗与住院治疗之间的差异。

方法

这项回顾性病例对照研究纳入了2020年1月1日至2022年12月31日在中国一家三级甲等医院急诊科接受治疗的1889例CAP患者。患者被分为接受急诊计划性再输注治疗或住院治疗的组。采用独立样本t检验和χ检验比较两组在不同肺炎严重程度指数（PSI）分类下的临床结局和经济影响。

结果

该研究共纳入1889例CAP患者。对于PSI I-II级患者，急诊计划性再输注治疗组的改善率为99.51%，住院治疗组为99.69%，差异无统计学意义（P>0.05）。同样，PSI III级患者也未观察到显著差异（84.16%对89.82%）。然而，PSI IV级患者出现了显著差异，急诊计划性再输注治疗组的改善率为50%，住院治疗组为90.59%（P<0.001）。两组在治疗持续时间（5.13±1.65天对7.60±3.93天，P<0.001）和总治疗费用（1921.57元人民币（CNY）±923.16对9083.80元人民币±3583.55，P<0.001）方面也存在统计学显著差异。