Evidence map›Paper›PMID 29404940›Full record

ArticleJournal of general internal medicine2018

Impact of Procalcitonin Guidance on Management of Adults Hospitalized with Chronic Obstructive Pulmonary Disease Exacerbations.

Derek N Bremmer, Briana E DiSilvio, Crystal Hammer, Moeezullah Beg, Swati Vishwanathan, Daniel Speredelozzi, Matthew A Moffa, Kurt Hu, Rasha Abdulmassih, Jina T Makadia and 8 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of general internal medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Review
  4. Review
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 3 institutions in 1 country.

Derek N BremmerDepartment of Pharmacy, Allegheny Health Network, The Western Pennsylvania Hospital, Pittsburgh, PA, USA.
Briana E DiSilvioDepartment of Medicine, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, PA, USA.
Crystal HammerDepartment of Medicine, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, PA, USA.
Moeezullah BegDepartment of Medicine, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, PA, USA.
Swati VishwanathanDepartment of Medicine, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, PA, USA.
Daniel SperedelozziDepartment of Medicine, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, PA, USA.
Matthew A MoffaDivision of Infectious Diseases, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, PA, USA.
Kurt HuDepartment of Medicine, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, PA, USA.
Rasha AbdulmassihDivision of Infectious Diseases, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, PA, USA.
Jina T MakadiaDivision of Infectious Diseases, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, PA, USA.
Rikinder SandhuDivision of Infectious Diseases, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, PA, USA.
Mouhib NaddourDepartment of Medicine, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, PA, USA.
Noreen H Chan-TompkinsDepartment of Pharmacy, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, PA, USA.
Tamara L TrienskiDepartment of Pharmacy, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, PA, USA.
Courtney WatsonCenter for Inclusion Health, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, PA, USA.
Terrence J ObringerDivision of Pulmonary Medicine, Allegheny Health Network, The Western Pennsylvania Hospital, Pittsburgh, PA, USA.
Jim KuzyckDepartment of Microbiology, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, PA, USA.
Thomas L WalshDivision of Infectious Diseases, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, PA, USA. Thomas.Walsh@ahn.org.
Allegheny General Hospital · USAllegheny Health Network · USWestern Pennsylvania Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntibiotics are often prescribed for hospitalized patients with chronic obstructive pulmonary disease (COPD) exacerbations. The use of procalcitonin (PCT) in the management of pneumonia has safely reduced antibiotic durations, but limited data on the impact of PCT guidance on the management of COPD exacerbations remain.

objectiveTo determine the impact of PCT guidance on antibiotic utilization for hospitalized adults with exacerbations of COPD.

designA retrospective, pre-/post-intervention cohort study was conducted to compare the management of patients admitted with COPD exacerbations before and after implementation of PCT guidance. The pre-intervention period was March 1, 2014, through October 31, 2014, and the post-intervention period was March 1, 2015, through October 31, 2015.

participantsAll patients with hospital admissions during the pre- and post-intervention period with COPD exacerbations were included. Patients with concomitant pneumonia were excluded.

interventionAvailability of PCT laboratory values in tandem with a PCT guidance algorithm and education. MAIN MEASURES: The primary outcome was duration of antibiotic therapy for COPD. Secondary objectives included duration of inpatient length of stay (LOS) and 30-day readmission rates. KEY

resultsThere were a total of 166 and 139 patients in the pre- and post-intervention cohorts, respectively. There were no differences in mean age (66.2 vs. 65.9; P = 0.82) or use of home oxygenation (34% vs. 39%; P = 0.42) in the pre- and post-intervention groups, respectively. PCT guidance was associated with a reduced number of antibiotic days (5.3 vs. 3.0; p = 0.01) and inpatient LOS (4.1 days vs. 2.9 days; P = 0.01). Respiratory-related 30-day readmission rates were unaffected (10.8% vs. 9.4%; P = 0.25).

conclusionsUtilizing PCT guidance in the management of COPD exacerbations was associated with a decreased total duration of antibiotic therapy and hospital LOS without negatively impacting hospital readmissions.

Indexed as

AgedAnti-Bacterial AgentsControlled Before-After StudiesDisease ProgressionFemaleHumansLength of StayMaleMiddle AgedPatient ReadmissionProcalcitoninPulmonary Disease, Chronic ObstructiveRetrospective StudiesAnti-Bacterial AgentsProcalcitoninantibioticschronic obstructive pulmonary diseaseprocalcitonin

Identifiers

PMID29404940
PMCPMC5910348
OpenAlexW2789260085

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.