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BMJ Open. 2018 Feb 15;8(2):e018709. doi: 10.1136/bmjopen-2017-018709.

Disease characteristics and management of hospitalised adolescents and adults with community-acquired pneumonia in China: a retrospective multicentre survey.

Author information

1
Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
2
Department of Infectious Disease, 4th Medical College of Peking University, Beijing Jishuitan Hospital, Beijing, China.
3
Department of Pulmonary and Critical Care Medicine, Center for Respiratory Diseases, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China.
4
Department of Respiratory Medicine, Yan'an Hospital, Kunming Medical University, Kunming, China.
5
Department of Respiratory Medicine, Qingdao Municipal Hospital, Qingdao, China.
6
Department of Respiratory Medicine, Beijing Huimin Hospital, Beijing, China.
7
Department of Respiratory Medicine, Linzi District People's Hospital, Zibo, China.
8
Department of Respiratory Medicine, Beijing Luhe Hospital, Capital Medical University, Weifang, China.
9
Department of Pulmonary and Critical Care Medicine, Weifang NO.2 People's Hospital, Weifang, China.
10
Department of Respiratory Medicine, Qilu Hospital Of Shandong University (Qindao), Qingdao, China.
11
Department of Respiratory Medicine, The 2nd Hospital of Beijing Corps, Chinese Armed Police Forces, Beijing, China.
12
Department of Infectious Disease, Yantai Yuhuangding Hospital, Yantai, China.
13
Department of Respiratory Medicine, Rizhao Chinese Medical Hospital, Shandong Chinese Medical University, Rizhao, China.
14
Occupational Medicine and Toxicology Department, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
15
Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
16
Departmentof Pulmonary Medicine, Capital Medical University, Beijing, China.

Abstract

OBJECTIVES:

To describe the clinical characteristics and management of patients hospitalised with community-acquired pneumonia (CAP) in China.

DESIGN:

This was a multicentre, retrospective, observational study.

SETTING:

13 teaching hospitals in northern, central and southern China from 1 January 2014 to 31 December 2014 PARTICIPANTS: Information on hospitalised patients aged ≥14 years with radiographically confirmed pneumonia with illness onset in the community was collected using standard case report forms.

PRIMARY AND SECONDARY OUTCOME MEASURES:

Resource use for CAP management.

RESULTS:

Of 14 793 patients screened, 5828 with radiographically confirmed CAP were included in the final analysis. Low mortality risk patients with a CURB-65 score 0-1 and Pneumonia Severity Index risk class I-II accounted for 81.2% (4434/5594) and 56.4% (2034/3609) patients, respectively. 21.7% (1111/5130) patients had already achieved clinical stability on admission. A definite or probable pathogen was identified only in 12.7% (738/5828) patients. 40.9% (1575/3852) patients without pseudomonal infection risk factors received antimicrobial overtreatment regimens. The median duration between clinical stability to discharge was 5.0 days with 30-day mortality of 4.2%.

CONCLUSIONS:

These data demonstrated the overuse of health resources in CAP management, indicating that there is potential for improvement and substantial savings to healthcare systems in China.

TRIAL REGISTRATION NUMBER:

NCT02489578; Results.

KEYWORDS:

China; community-acquired pneumonia; disease characteristics; management

PMID:
29449294
PMCID:
PMC5829872
DOI:
10.1136/bmjopen-2017-018709
[Indexed for MEDLINE]
Free PMC Article

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