Finding New Ways to Manage Medically Complex Patients with Pneumonia

Published November 2016
The Journal of Pediatrics

Cincinnati Children’s takes care of a large and increasing number of children with neurologic impairment. However, doctors in many medical centers have been searching for better ways to manage the increased risk these patients often face for developing bacterial pneumonia.

“This is a growing population in pediatrics,” said Joanna Thomson, MD, MPH, a physician in the Division of Hospital Medicine. “Pneumonia is important to their health outcomes, as it is one of the most common reasons for admission and the most common cause of death.”

Yet doctors have known little about the optimal management for pneumonia in children with neurologic impairment because that population was excluded from most pneumonia studies and guidelines, Thomson says. This inspired her to organize a new study with a huge cohort—27,455 children with neurologic impairment hospitalized with pneumonia at 39 children’s hospitals.

The research team found wide variation in diagnostic testing across hospitals. They also found that higher rates of testing were not associated with improved outcomes, which suggests an opportunity to reduce unnecessary diagnostic testing.

“This study represents a first step toward determining the best management for these children when they are hospitalized with pneumonia,” Thomson says.

It also suggests there is potential to “safely do less,” said Samir Shah, MD, MSCE, director of the Division of Hospital Medicine. “This is an area where hospitalists excel that will contribute to better patient outcomes at a lower cost.”