Pneumonia: New Prediction Model Proves Promising. Research Findings forClinicians

摘要

A new clinical prediction model can help clinicians determine the mostappropriate care for newly diagnosed cases of community-acquired pneumonia (CAP). The model recently was announced by a team of researchers supported through a grant from the Federal Agency for Health Care Policy and Research (AHCPR). The model stratifies patients into risk categories based on their medical history, physical examination findings, and a limited set of laboratory and radiographic results. This is a major breakthrough, since the factors used to predict risk and clearly defined and can be readily assessed at the time of patient presentation. The model also predicts other important medical outcomes, such as length of hospitalization, admission to an intensive care unit for respiratory failure or hemodynamic compromise, and time to return to usual activities. About 600,000 of the 4 million Americans who develop CAP each year are hospitalized. Because of a lack of evidence-based admission criteria and the tendency to overestimate the risk of death, many low-risk patients who could just as safely be treated as outpatients are instead admitted for more costly inpatient care.