Predictive value of history and physical examination for the diagnosis of community-acquired pneumonia in adults

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dc.contributor.authorSaldias, Fernando
dc.contributor.authorCabrera, Daniel
dc.contributor.authorde Solminihac, Ignacio
dc.contributor.authorHernandez, Pamela
dc.contributor.authorGederlini, Alessandra
dc.contributor.authorDiaz, Alejandro
dc.date.accessioned2025-01-21T01:05:39Z
dc.date.available2025-01-21T01:05:39Z
dc.date.issued2007
dc.description.abstractBackground- Community-acquired pneumonia in adults is a serious health problem in the ambulatory care setting. Aim To define clinical variables associated with the presence of pneumonia in adult patients presenting with fever or respiratory symptoms to the emergency department. Material and methods: Prospective study carried out in the emergency department from the Catholic University Hospital in Santiago, Chile. Three hundred twenty-five patients (53 22 years) presenting fever or acute respiratory symptoms were included. After obtaining a clinical history and physical examination, the physician established a tentative diagnosis. Subsequently, a definitive diagnosis was made with the chest X rays. Results: Thirty-four percent of the patients had pneumonia. The clinical diagnosis of pneumonia before X-ray examination, was variable among emergency physicians (positive likelihood ratio 1.5-4.8) and showed only moderate sensitivity (79%) and specificity (66%). The clinical variables significantly associated with the presence of pneumonia were: advanced age (over 75 years), cardiovascular disease, fever, chills, sputum production, orthopnea, altered mental status, cyanosis, dullness on percussion, bronchial breath sounds, crackles, any abnormal vital sign (heart rate >= 100 beats/min, respiratory rate >= 20 breaths/min or temperature >= 38 degrees C) and oxygen. saturation below 90% breathing air Conclusions: Clinical judgment prior to observation. of chest X rays had moderate sensitivity and specificity for the diagnosis of pneumonia. There were no individual clinical findings, or combination of findings, that could confirm or exclude the diagnosis of pneumonia for a patient suspected of having this illness.
dc.fuente.origenWOS
dc.identifier.eissn0717-6163
dc.identifier.issn0034-9887
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/95980
dc.identifier.wosidWOS:000245412600001
dc.issue.numero2
dc.language.isoen
dc.pagina.final152
dc.pagina.inicio143
dc.revistaRevista medica de chile
dc.rightsacceso restringido
dc.subjectdiagnosis, differential
dc.subjectpneumonia
dc.subjectradiography
dc.subjectthoracic
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titlePredictive value of history and physical examination for the diagnosis of community-acquired pneumonia in adults
dc.typeartículo
dc.volumen135
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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