Bronchoalveolar Lavage in Immunocompetent Patients with Pneumonia: A Retrospective Cohort Study Shows No Survival Benefit
Bibliographic record
Abstract
Background: Bronchoalveolar lavage (BAL) is frequently employed for diagnostic purposes in immunocompromised patients with pneumonia, yet its role in immunocompetent individuals remains debated. The study investigates whether BAL is associated with reduced mortality in immunocompetent patients hospitalized with pneumonia. Methods: A retrospective cohort study was conducted at SMC, including 13,180 immunocompetent patients hospitalized with pneumonia from 2007 to 2024. Patients who underwent BAL (n = 96) were matched 1: 4 to a control group (n = 384) using Propensity score matching based on age, gender, severity scores and comorbidities. Mortality was assessed at 30, 60, and 90 days using logistic regression models, adjusting for length of stay, inflammatory markers, albumin levels, smoking status, and BMI. Results: In the matched cohort, 30-day mortality did not differ significantly between groups (20.8% in BAL vs. 19.5% in controls, p = 0.886), and no significant association was observed after adjustment (OR = 0.95 [0.51–1.73]. However, both 60-day and 90-day mortality were significantly higher in the BAL group (39.6% vs. 24.7% and 45.8% vs. 26.8%, respectively; p < 0.01 for both), and these differences persisted after adjustment (60 days: OR = 1.74 [1.03–2.94]; 90 days: OR = 2.12 [1.27–3.54]). Conclusions: In this cohort of immunocompetent patients hospitalized with pneumonia, BAL was not associated with short-term survival. Clinicians should carefully weigh the potential risks and benefits of BAL in this population. Further studies are needed to identify patient subgroups that might benefit from BAL through enhanced diagnostic or therapeutic approaches.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".