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Clinical and Laboratory Findings in Patients With Acute Respiratory Symptoms That Suggest the Necessity of Chest X-ray for Community-Acquired Pneumonia

BACKGROUND: Pneumonia is a common illness in all parts of the world and is considered as a major cause of death among all age groups. Nevertheless, only about 5% of patients referring to their primary care physicians with acute respiratory symptoms will develop pneumonia. OBJECTIVES: This study was...

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Autores principales: Ebrahimzadeh, Azadeh, Mohammadifard, Mahyar, Naseh, Godratallah, Mirgholami, Alireza
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kowsar 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4347759/
https://www.ncbi.nlm.nih.gov/pubmed/25785179
http://dx.doi.org/10.5812/iranjradiol.13547
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author Ebrahimzadeh, Azadeh
Mohammadifard, Mahyar
Naseh, Godratallah
Mirgholami, Alireza
author_facet Ebrahimzadeh, Azadeh
Mohammadifard, Mahyar
Naseh, Godratallah
Mirgholami, Alireza
author_sort Ebrahimzadeh, Azadeh
collection PubMed
description BACKGROUND: Pneumonia is a common illness in all parts of the world and is considered as a major cause of death among all age groups. Nevertheless, only about 5% of patients referring to their primary care physicians with acute respiratory symptoms will develop pneumonia. OBJECTIVES: This study was performed to derive practical criteria for performing chest radiographs for the evaluation of community-acquired pneumonia (CAP). PATIENTS AND METHODS: A total of 420 patients with acute respiratory symptoms and positive findings on chest radiograph were evaluated from December 2008 to December 2009. The subjects were referred to outpatient clinics or emergency departments of Birjand's medical university hospitals, Iran, and were enrolled as positive cases. A checklist was completed for each patient including their demographic information, clinical signs and symptoms (cough, sputum production, dyspnea, chest pain, fever, tachycardia, and tachypnea), abnormal findings in pulmonary auscultation and laboratory findings (erythrocyte sedimentation rate, C-reactive protein levels, and white blood cell count). An equal number of age-matched individuals with acute respiratory symptoms, but insignificant findings on chest radiography, were included as the control group. Finally, the diagnostic values of different findings were compared. RESULTS: The data showed that vital signs and physical examination findings are useful screening parameters for predicting chest radiograph findings in outpatient settings. Therefore, by implementing a prediction rule, we would be able to determine which patients would benefit from a chest X-Ray (sensitivity, 94% and specificity, 57%). CONCLUSIONS: This study's findings suggest that requesting chest radiographs might not be necessary in patients with acute respiratory symptoms unless the vital signs and/or physical examination findings are abnormal. Considering the 94% sensitivity of this rule for predicting CAP, a chest radiograph is required for patients with unreliable follow-ups or moderate to high likelihood of morbidity if CAP is not initially detected.
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spelling pubmed-43477592015-03-17 Clinical and Laboratory Findings in Patients With Acute Respiratory Symptoms That Suggest the Necessity of Chest X-ray for Community-Acquired Pneumonia Ebrahimzadeh, Azadeh Mohammadifard, Mahyar Naseh, Godratallah Mirgholami, Alireza Iran J Radiol Chest Imaging BACKGROUND: Pneumonia is a common illness in all parts of the world and is considered as a major cause of death among all age groups. Nevertheless, only about 5% of patients referring to their primary care physicians with acute respiratory symptoms will develop pneumonia. OBJECTIVES: This study was performed to derive practical criteria for performing chest radiographs for the evaluation of community-acquired pneumonia (CAP). PATIENTS AND METHODS: A total of 420 patients with acute respiratory symptoms and positive findings on chest radiograph were evaluated from December 2008 to December 2009. The subjects were referred to outpatient clinics or emergency departments of Birjand's medical university hospitals, Iran, and were enrolled as positive cases. A checklist was completed for each patient including their demographic information, clinical signs and symptoms (cough, sputum production, dyspnea, chest pain, fever, tachycardia, and tachypnea), abnormal findings in pulmonary auscultation and laboratory findings (erythrocyte sedimentation rate, C-reactive protein levels, and white blood cell count). An equal number of age-matched individuals with acute respiratory symptoms, but insignificant findings on chest radiography, were included as the control group. Finally, the diagnostic values of different findings were compared. RESULTS: The data showed that vital signs and physical examination findings are useful screening parameters for predicting chest radiograph findings in outpatient settings. Therefore, by implementing a prediction rule, we would be able to determine which patients would benefit from a chest X-Ray (sensitivity, 94% and specificity, 57%). CONCLUSIONS: This study's findings suggest that requesting chest radiographs might not be necessary in patients with acute respiratory symptoms unless the vital signs and/or physical examination findings are abnormal. Considering the 94% sensitivity of this rule for predicting CAP, a chest radiograph is required for patients with unreliable follow-ups or moderate to high likelihood of morbidity if CAP is not initially detected. Kowsar 2015-01-01 /pmc/articles/PMC4347759/ /pubmed/25785179 http://dx.doi.org/10.5812/iranjradiol.13547 Text en Copyright © 2015, Tehran University of Medical Sciences and Iranian Society of Radiology. http://creativecommons.org/licenses/by-nc/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
spellingShingle Chest Imaging
Ebrahimzadeh, Azadeh
Mohammadifard, Mahyar
Naseh, Godratallah
Mirgholami, Alireza
Clinical and Laboratory Findings in Patients With Acute Respiratory Symptoms That Suggest the Necessity of Chest X-ray for Community-Acquired Pneumonia
title Clinical and Laboratory Findings in Patients With Acute Respiratory Symptoms That Suggest the Necessity of Chest X-ray for Community-Acquired Pneumonia
title_full Clinical and Laboratory Findings in Patients With Acute Respiratory Symptoms That Suggest the Necessity of Chest X-ray for Community-Acquired Pneumonia
title_fullStr Clinical and Laboratory Findings in Patients With Acute Respiratory Symptoms That Suggest the Necessity of Chest X-ray for Community-Acquired Pneumonia
title_full_unstemmed Clinical and Laboratory Findings in Patients With Acute Respiratory Symptoms That Suggest the Necessity of Chest X-ray for Community-Acquired Pneumonia
title_short Clinical and Laboratory Findings in Patients With Acute Respiratory Symptoms That Suggest the Necessity of Chest X-ray for Community-Acquired Pneumonia
title_sort clinical and laboratory findings in patients with acute respiratory symptoms that suggest the necessity of chest x-ray for community-acquired pneumonia
topic Chest Imaging
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4347759/
https://www.ncbi.nlm.nih.gov/pubmed/25785179
http://dx.doi.org/10.5812/iranjradiol.13547
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