Etiology, reasons for hospitalization, risk classes, and outcomes of community-acquired pneumonia in patients hospitalized on the basis of conventional admission criteria
Etiology, reasons for hospitalization, risk classes, and outcomes of community-acquired pneumonia in patients hospitalized on the basis of conventional admission criteria
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DOI：
10.1086/321808
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发表时间：
2001-07-15
影响因子：
11.8
通讯作者：
Gudiol, F
中科院分区：
文献类型：
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作者：
Rosón, B;Carratalà, J;Gudiol, F
我们对533例非严重免疫抑制成人患者的前瞻性收集数据进行了观察性分析，这些患者根据常规入院标准因社区获得性肺炎住院。对于这一人群，我们使用肺炎严重程度指数（PSI）将病因、入院原因和结局相关联，以确定PSI风险等级与决定护理部位的传统标准之间的主要差异。PSI分级和相应的死亡率如下：I级，51例患者（0%）; II级，62例（2%）; III级，117例（3%）; IV级，198例（10%）; V级，105例（29%）。我们发现两种方法之间存在显著差异。总体而言，230例（40%）根据传统标准住院的患者被分配到低风险类别。在这230例患者中，137例（60%）需要补充氧气或有胸膜并发症;其余患者没有不可辩驳的入院原因。后一组值得在比较门诊和住院管理的随机研究中进行前瞻性评价。
We performed an observational analysis of prospectively collected data on 533 nonseverely immunosuppressed adult patients who were hospitalized for community-acquired pneumonia on the basis of conventional admission criteria. For this population, we correlated etiology, reasons for admission, and outcomes using the Pneumonia Severity Index (PSI), to identify major discrepancies between the PSI risk class and the conventional criteria for deciding the site of care. PSI classes and corresponding mortality rates were as follows: class I, 51 patients (0%); class II, 62 (2%); class III, 117 (3%); class IV, 198 (10%); and class V, 105 (29%). We identified significant discrepancies between both methods. Overall, 230 patients (40%) who were hospitalized according to conventional criteria were assigned to low-risk classes. Of these 230 patients, 137 (60%) needed supplementary oxygen or had pleural complications; for the remaining patients, there were no irrefutable reasons for admission. This latter group deserves prospective evaluation in randomized studies that compare ambulatory and in-hospital management.