Acute lower respiratory tract infections:Symptoms, findings and management in Danish general practice

Background: Acute lower respiratory tract infections (LRTIs) are among the most common infections managed in general practice.Objectives: To describe differences in reported symptoms, findings and management of patients diagnosed with acute LRTIs, and to explore possible associations between these findings and being diagnosed with pneumonia.Methods: During one winter season (2017 or 2018), a prospective registration of patients diagnosed with either acute bronchitis (ICPC-2: R78) or pneumonia (ICPC-2: R81) was conducted in Danish general practice for 20 days. A 42 item registration chart was filled in for each patient. Descriptive statistics, Pearson's chi-square test and multiple logistic regressions were used for data analysis.Results: In total, 70 general practices participated with 1384 patients registered. Patients diagnosed with pneumonia were more often reported as having a fever, dyspnoea, increased purulent sputum, abnormal pulmonary auscultation/chest retractions, and were more often assessed as unwell by the healthcare professional, than those diagnosed with acute bronchitis. Very few patients had a chest X-ray. Contrary, most patients had a C-reactive protein (CRP) test performed (pneumonia: 83%; acute bronchitis: 71%). Respectively, 93% and 20% of patients were treated with antibiotics. Having a fever, an abnormal pulmonary auscultation/chest retractions or being assessed as unwell increased the likelihood of the diagnosis pneumonia at least fivefold. Even a slightly elevated CRP (≥11 mg/L) was positively associated with being diagnosed with pneumonia.Conclusion: Danish healthcare professionals are highly influenced by symptoms, signs and CRP tests when diagnosing patients with acute LRTIs in general practice.

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PID https://www.doi.org/10.1080/13814788.2019.1674279
PID pmc:PMC7034054
PID pmid:31650886
PID https://www.doi.org/10.6084/m9.figshare.10048505.v1
PID https://www.doi.org/10.6084/m9.figshare.10048505
URL http://dx.doi.org/10.6084/m9.figshare.10048505.v1
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URL https://vbn.aau.dk/en/publications/acute-lower-respiratory-tract-infections-symptoms-findings-and-ma
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URL http://dx.doi.org/10.1080/13814788.2019.1674279
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URL http://dx.doi.org/10.6084/m9.figshare.10048505
URL https://www.ncbi.nlm.nih.gov/pubmed/31650886
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URL https://doaj.org/toc/1751-1402
URL https://doi.org/10.1080/13814788.2019.1674279
URL https://portal.findresearcher.sdu.dk/da/publications/eb052c1e-b5f7-4133-9cff-9bdacfc33348
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URL http://europepmc.org/articles/PMC7034054
URL https://www.tandfonline.com/doi/pdf/10.1080/13814788.2019.1674279
URL https://portal.findresearcher.sdu.dk/da/publications/acute-lower-respiratory-tract-infections-symptoms-findings-and-ma
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Access Right Open Access
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Author Janus Laust Thomsen, 0000-0002-0745-6815
Author Jesper Lykkegaard, 0000-0001-9128-6136
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Collected From PubMed Central; VBN; ORCID; figshare; Datacite; UnpayWall; University of Southern Denmark Research Output; DOAJ-Articles; Crossref; Microsoft Academic Graph
Hosted By Europe PubMed Central; VBN; figshare; University of Southern Denmark Research Output; European Journal of General Practice
Publication Date 2019-10-25
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Country Denmark
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Language English
Resource Type Other literature type; Article
keyword FOS: Health sciences
keyword FOS: Biological sciences
keyword FOS: Clinical medicine
system:type publication
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Source https://science-innovation-policy.openaire.eu/search/publication?articleId=dedup_wf_001::52d57375e6f019a7469afdbaf943975a
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Last Updated 26 December 2020, 05:02 (CET)
Created 26 December 2020, 05:02 (CET)