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住院患者患有社区获得的肺炎的临床稳定时间:对实践指南的影响
E A Halm1, M J Fine, T J Marrie
1Department of Health Policy, Mount Sinai School of Medicine, New York, NY 10029, USA. ethanvhalm@smtplink.mssm.edu
肺炎患者通常在3-7天内达到临床稳定. 这项研究提供了基于证据的最佳住院时间标准,提高了住院患者管理效率.
科学领域:
- 肺部医学 肺部医学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 有指导方针可减少肺炎的住院时间,但临床稳定的最佳时间尚未定义.
- 确定临床稳定性对于有效的住院治疗和降低成本至关重要.
研究的目的:
- 确定住院社区获得性肺炎患者的生命体征,饮食能力和精神状况的解决时间.
- 为了评估稳定性后的临床结果.
主要方法:
- 前性,多中心,观察性队列研究.
- 这项研究涉及686名患有社区性肺炎的成年人,涉及三个大学和一个社区教学医院.
- 对生命体征,进食能力,精神状态,停留时间和ICU/监控单位入院的测量时间.
主要成果:
- 生命体征稳定的中位时间在2-3天之间.
- 根据定义,总体临床稳定性平均在3至7天内达到.
- 稳定后的临床恶化很少 (≤1%).
- 大多数患者在稳定后仍住院超过1天,转换为口服抗生素的情况有变化.
结论:
- 提供基于证据的估计时间到肺炎稳定性.
- 建立了明确的标准来定义稳定性.
- 为优化住院管理和住院时间提供了一个框架.
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