Early Versus Delayed Bronchoalveolar Lavage in Hospitalized Patients With Coal Workers' Pneumoconiosis and Pneumonia: A Retrospective Cohort Study of Inflammatory and Radiographic Outcomes
Zhengjun Wen, Liang Chen, Jianhong ZhangObjective:
Assess whether BAL timing (≤72 h vs. >72 h) affects inflammation, radiographic outcomes, and resource use in patients with CWP complicated by pneumonia.
Methods:
This single-center cohort included 204 patients treated from 2020 to 2024. Associations were evaluated using GEE, multivariable regression, and IPTW.
Results:
Patients receiving early BAL had higher baseline inflammation and showed steeper CRP and WBC declines in adjusted and weighted analyses. Radiographic estimates were imprecise, and no clear adjusted differences were observed in length of stay or total cost.
Conclusions:
Early BAL (≤72 h) was associated with greater short-term inflammatory improvement. However, residual confounding, regression to the mean, missing data, and survival/immortal-time biases limit causal interpretation. Benefits for radiographic outcomes and healthcare resource use remain uncertain.