文摘

背景:住院的社区获得性肺炎的仍然是一个重要的原因,有明显的死亡率。入学期间严重程度的评估标准已由英国胸学会(BTS)。进行一项研究以确定严重程度的敏感性和特异性规则基于BTS预后的修改规则应用于承认,比较严重,评估通过医务人员修改规则,并确定在克赖斯特彻奇社区获得性肺炎的微生物原因。方法:12个月的研究所有成年人承认克赖斯特彻奇医院与社区获得性肺炎。连续三百一十六例疑似社区获得性肺炎患者筛查包容。从历史,获得变量检查,调查,和初始治疗检查与死亡率。结果:二百五十五例患者符合入选标准。他们的平均年龄是58年(18 - 97)。微生物诊断,181例(71%),肺炎链球菌(39%),肺炎支原体(16%)、军团菌属物种(11%),和流感嗜血杆菌(11%)是最常见的生物识别。患者36-fold增加死亡的风险,如果有下列在场的两个承认:呼吸率> = 30 /分钟,心脏舒张BP <或= 60毫米汞柱,尿素> 7更易/ l,或混乱。 The severity rule identified 19 of the 20 patients who died and six of eight patients admitted to the intensive care unit as having life threatening community acquired pneumonia. The sensitivity of the modified rule for predicting death was 0.95 and the specificity 0.71. In 47 cases (21%) the clinical team appeared to underestimate the severity of the illness. CONCLUSIONS: The organisms responsible for community acquired pneumonia in Christchurch are similar to those reported from other centres except for Legionella species which were more common than in most studies. The modification of the BTS prognostic rules applied as a severity indicator at admission performed well and could be incorporated into management guidelines.