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The application of big data and artificial intelligence technology in the medical field is key to hospital informatization. In October 2018, a tertiary hospital launched a clinical intelligent application platform. The platform took AI assistant as the carrier of intelligent application, supported the role expansion, function expansion and connotation expansion of intelligent application, and layed the foundation for the construction of clinical intelligence. As of July 2022, the platform had been embedded into the outpatient, emergency and inpatient business systems with the help of AI assistant, realizing such intelligent applications as auxiliary diagnosis, auxiliary treatment, risk warning, AI medical record quality control, research entry group and infectious disease management, as well as enriching the connotation of such specialty applications as orthopedics and ear, nose and throat. The platform satisfied the integration and integration of hospital information construction and provided convenient and effective intelligent auxiliary tools for clinical use.
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Objective:To analyze the clinical characteristics and short-term prognosis of patients with acute asthmatic attack and comorbid bronchiectasis.Methods:The data of patients hospitalized for acute asthmatic attack in the Department of Respiratory and Critical Care Medicine of Peking University Third Hospital from January 1, 2012 to December 31, 2021 were retrospectively collected and analyzed. According to whether or not co-existing with bronchiectasis, all the patients were divided into asthmatic with bronchiectasis group and asthmatic without bronchiectasis group. Then the general conditions, comorbidities, pulmonary function test, grades of asthma severity, laboratory examination and in-hospital short-term prognosis of two groups were analyzed.Results:A total of 580 hospitalized patients with acute asthma attack were included, of which 132 cases (22.76%) were classified into asthmatic with bronchiectasis group and 448 cases (77.24%) were classified into asthmatic without bronchiectasis group. Co-existing with obsolete pulmonary tuberculosis and anxiety/depression in asthmatic with bronchiectasis group were more common than that in asthmatic without bronchiectasis group (13.64% vs 5.36%; 7.58% vs 2.68%) (both P<0.05). The pre-bronchodilator forced vital capacity (FVC) and its percentage to the predicted value (FVC%pred), forced expiratory volume in 1 second (FEV 1) and its percentage to the predicted value (FEV 1%pred), FEV 1/FVC and post-bronchodilator FEV 1 in asthmatic with bronchiectasis group were lower than those in the asthmatic without bronchiectasis group [2.44 (1.90, 3.01) vs 2.69 (2.10, 3.68) L, 1.55 (1.13, 2.00) vs 1.78 (1.25, 2.52) L, 70.14% (67.39%, 85.92%) vs 79.63% (70.00%, 89.52%), 70.00% (54.38%, 78.11%) vs 70.00% (61.47%, 85.00%), 61.57% (56.29%, 73.03%) vs 66.67% (60.00%, 75.00%), 1.72 (1.21, 2.18) vs 1.89 (1.37, 2.55) L] (all P<0.05). In previous year, the proportion of patients receiving hospitalization due to acute asthmatic attack in asthmatic with bronchiectasis group was higher than that in asthmatic without bronchiectasis group (15.15% vs 8.93%) ( P<0.05). The peak months of hospitalization due to acute asthmatic attack in asthmatic with bronchiectasis group were April, July and October, and the peak months in asthmatic without bronchiectasis group were April and September. The length of hospital stay was longer and the proportion of patients receiving invasive ventilation was higher in asthmatic with bronchiectasis group than those in asthmatic without bronchiectasis group [10.06 (7.62, 13.94) vs 9.95 (7.15, 13.76) d; 5.30% vs 2.01%] (both P<0.05). The risk factors for invasive mechanical ventilation in asthmatic patients with acute attack during hospitalization were co-existing with bronchiectasis, smoking, high level of partial pressure of carbon dioxide in arterial blood, serum creatinine and creatine kinase. Conclusion:Asthma patients with comorbid bronchiectasis have more frequent acute attack, a longer hospitalization due to acute asthmatic attack and a higher probability of invasive ventilation during hospitalization.
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Objective:To investigate the use of antibacterial agents for emergency patients with acute upper respiratory infections in tertiary hospitals in Beijing .Methods:We used the medical claim data for urban workers in 10 tertiary hospitals in Beijing from Oct .2010 to Sep.2012.Medical records of emer-gency patients with acute upper respiratory tract infections had been selected as the study sample .The proportions of antibacterial prescriptions and categories of antibacterial drugs were described and ana -lyzed.Results:This study included 135 979 visitors (male:42.7%;mean age:43.6 ±16.2 years).The average antibacterial prescription rate was 71.2% (95%CI 71.0%-71.5%), of which the single kind use was 80.0%(95%CI 79.7%-80.2%).Among acute upper respiratory tract infections , the antibacte-rial prescription rate for acute tonsillitis visits was highest (85.1%, 95%CI 84.5%-85.6%), followed by acute laryngitis and bronchitis (81.69%, 95%CI 80.4%-82.8%), acute pharyngitis (81.4%, 95%CI 77.7% -85.0%), acute sinusitis (77.0%, 95%CI 74.6% -79.4%), acute nasopharyngitis (74.3%, 95%CI 73.7%-75.0%), and common cold (67.6%, 95%CI 67.3%-67.9%).Compared with the female group, the antibacterial prescription rate for the male was higher (73.2%, 95%CI 72.8%-73.6%vs.69.7%, 95%CI 69.4%-70.0%).Compared with the <60 years age cases, the anti-bacterial prescription rate for the ≥60 years cases was higher (72.1%, 95%CI 71.8%-72.3% vs. 66 .8%, 95%CI 66 .2%-67 .5%) .In the visitors who used antibacterial drugs , the average percentage of injection use was 50.6%(95%CI 50.3%-50.9%).The top antibacterial drugs in the list of varie-ties were the second generation cephalosporins (28.4%) , followed by the third generation cephalosporins (21.7%), fluoroquinolones (21.0%) and macrolides (17.6%).Conclusion: The antibacterial pre-scription rate for acute upper respiratory tract infections in the general hospitals in Beijing is high , and the second generation cephalosporins , third generation cephalosporins , fluoroquinolones and macrolides take the lead in the total antibacterial drugs .