Association of clinically significant diagnostic yield with the timing (early versus late) of computed tomography of the chest in critically ill patients with nonresponding pneumonia: A retrospective analysis from a tertiary care center.
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- AIIMS
- 入组人数
- 268
- 试验地点
- 1
- 主要终点
- To evaluate the association of treatment change event rate with the timing of CT chest (early versus late) in critically ill patients with nonresponding pneumonia.
研究概览
简要总结
The incidence of nonresponding pneumonia ranges from 10 to 15 percentage in community-acquired and 30 to 60 percentage in nosocomial pneumonia. Chest computed tomography is an indispensable diagnostic and management tool for critically ill patients with nonresponding pneumonia. It enhances diagnostic accuracy, identifies alternative diagnoses, assesses disease severity, monitors progression, and aids in interventional procedures. However, its use should be balanced against potential risks and resource limitations, ensuring it is applied judiciously in clinical practice**.** Appropriate timing of the CT is crucial to derive clinically significant finding which will be beneficial for treatment of the patient. Hence, we conduct this study to find if the clinically significant findings in early or late CT chest impacts treatment outcomes in critically ill patients with nonresponding pneumonia**.** We also aim to identify other risk factors associated with a clinically significant diagnosis. This can help in better timing and patient selection for CT chest to improve treatment outcomes of critically ill patients with nonresponding pneumonia.
研究设计
- 研究类型
- Observational
入排标准
- 年龄范围
- 18.00 Year(s) 至 99.00 Year(s)（—）
- 性别
- All
入选标准
- •1.Patients admitted to the ICU who underwent CT chest for evaluation of nonresponding pneumonia after 72 hours of starting or a change in the antibiotic therapy.
- •2.If multiple imaging is being done for the same patient, the outcome of each scan will be counted separately.
排除标准
- •1.Patients who did not undergo any CT chest during their ICU stay.
- •2.Patients who underwent CT chest before or within 72 hours of the commencement of antibiotic therapy.
- •3.Patients with incomplete data on the day of commencement of antibiotic therapy before admission.
- •4.CT scan done before ICU admission.
- •5.CT scans performed for indications other than NRP or for interventional imagery, such as a CT pulmonary embolism or CT scan-guided procedures that the patient underwent.
- •6.Pregnancy 7.Known case of pulmonary tuberculosis, malignancy and bronchiectasis.
结局指标
主要结局
To evaluate the association of treatment change event rate with the timing of CT chest (early versus late) in critically ill patients with nonresponding pneumonia.
时间窗: After approval by CTRI, the data will be collected from ICU charts will be reviewed by retrospective chart review at the following timepoints: | 1.On the day of ICU admission for baseline data. | 2.On the day of CT chest imaging and next day for the diagnostic yield and any treatment change event | 3.Till the last day of ICU stay for estimation of duration of ICU stay, mechnical ventilation outcomes and mortality.
次要结局
- 1.To compare the sensitivity & specificity of the early versus late CT chest.(2.To compare the correlation of the CT findings with the final microbiological diagnosis in early versus late CT chest groups.)
研究者
Meenupriya Arasu
All India Institute of Medical Sciences, New Delhi