New pneumonia treatment method reduces mortality, Utah study says

A new method for treating pneumonia in emergency rooms has reduced mortality rates by 38%, according to a study published by researchers at Intermountain Healthcare.

In the study, clinicians treated patients using a real-time electronic decision support system called an ePNa. The system makes recommendations to bedside clinicians about how to treat patients.

The support system was used at 16 Intermountain hospitals from December 2017 to June 2019 to treat 67% of the almost 7,000 pneumonia cases hospitalized in that span.

The study found that after using the ePNa, there was a 38% relative reduction in mortality 30 days after a pneumonia diagnosis, including a large reduction in mortality for patients admitted to intensive care.

Researchers also found a 17% increase in "outpatient disposition," a decrease in admissions to intensive care units and a decrease in the time between emergency department admission and when a patient is first given an antibiotic.

An Intermountain statement says the results are consistent with what health officials saw when they first used ePNa at the company’s larger hospitals.

"Treating pneumonia in emergency departments is challenging, especially in community hospitals that don't see severe pneumonia as often as urban academic medical centers," said Dr. Nathan Dean, chief of pulmonary and critical care medicine at Intermountain Medical Center and principal investigator for the study.

Dean said that ePNa, in addition to making helpful recommendations, allows for treatment from clinicians to be more structured and could decrease unnecessary variations.

"Even if they don't follow the recommendation, decision-making is more consistent with best practices," Dean said.

Intermountain says pneumonia is the leading cause of death from infectious diseases in the United States, even before the pandemic.

U.S. News and World Report ranked Intermountain Healthcare as "high performing in pneumonia care with excellent outcomes" while the study was underway, Intermountain officials said.

The study, "A Pragmatic Stepped-wedge, Cluster-controlled Trial of Real-time Pneumonia Clinical Decision Support," was published Monday in the American Journal of Respiratory and Critical Care Medicine.