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Suspected community-acquired pneumonia in an ambulatory setting (CAPA): a French prospective observational cohort study in general practice.

Partouche H, Buffel du Vaure C, Personne V, Le Cossec C, Garcin C, Lorenzo A, Ghasarossian C, Landais P, Toubiana L, Gilberg S - NPJ Prim Care Respir Med (2015)

Bottom Line: Finally, 7% of patients were hospitalised and 0.3% died.Most patients consulting GPs for suspected CAP had the three following most common symptoms: cough, fever, and weakness or myalgia.More than a third of them were at increased risk for invasive pneumococcal disease.

View Article: PubMed Central - PubMed

Affiliation: Département de médecine générale, Faculté de médecine, Sorbonne Paris Cité, Université Paris Descartes, Paris, France.

ABSTRACT

Background: Few studies have addressed the pragmatic management of ambulatory patients with suspected community-acquired pneumonia (CAP) using a precise description of the disease with or without chest X-ray (X-ray) evidence.

Aims: To describe the characteristics, clinical findings, additional investigations and disease progression in patients with suspected CAP managed by French General Practitioners (GPs).

Methods: The patients included were older than 18 years, with signs or symptoms suggestive of CAP associated with recent-onset unilateral crackles on auscultation or a new opacity on X-ray. They were followed for up to 6 weeks. Descriptive analyses of all patients and according to their management with X-rays were carried out.

Results: From September 2011 to July 2012, 886 patients have been consulted by 267 GPs. Among them, 278 (31%) were older than 65 years and 337 (38%) were at increased risk for invasive pneumococcal disease. At presentation, the three most common symptoms, cough (94%), fever (93%), and weakness or myalgia (81%), were all observed in 70% of patients. Unilateral crackles were observed in 77% of patients. Among patients with positive radiography (64%), 36% had no unilateral crackles. A CRB-65 score was obtained in 62% of patients. Most patients (94%) initially received antibiotics and experienced uncomplicated disease progression regardless of their management with X-rays. Finally, 7% of patients were hospitalised and 0.3% died.

Conclusions: Most patients consulting GPs for suspected CAP had the three following most common symptoms: cough, fever, and weakness or myalgia. More than a third of them were at increased risk for invasive pneumococcal disease. With or without X-rays, most patients received antibiotics and experienced uncomplicated disease progression.

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Flowchart of patients included. GP, general practitioner.
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fig2: Flowchart of patients included. GP, general practitioner.

Mentions: Within the national training network, 425 selected investigators accepted to participate and 267 (63%) included at least one patient (Figure 1, Table 1). Between 21 September 2011 and 2 July 2012, 886 patients with suspected CAP were included. Data collected at the final visit were available for 865 patients (Figure 2).


Suspected community-acquired pneumonia in an ambulatory setting (CAPA): a French prospective observational cohort study in general practice.

Partouche H, Buffel du Vaure C, Personne V, Le Cossec C, Garcin C, Lorenzo A, Ghasarossian C, Landais P, Toubiana L, Gilberg S - NPJ Prim Care Respir Med (2015)

Flowchart of patients included. GP, general practitioner.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4373492&req=5

fig2: Flowchart of patients included. GP, general practitioner.
Mentions: Within the national training network, 425 selected investigators accepted to participate and 267 (63%) included at least one patient (Figure 1, Table 1). Between 21 September 2011 and 2 July 2012, 886 patients with suspected CAP were included. Data collected at the final visit were available for 865 patients (Figure 2).

Bottom Line: Finally, 7% of patients were hospitalised and 0.3% died.Most patients consulting GPs for suspected CAP had the three following most common symptoms: cough, fever, and weakness or myalgia.More than a third of them were at increased risk for invasive pneumococcal disease.

View Article: PubMed Central - PubMed

Affiliation: Département de médecine générale, Faculté de médecine, Sorbonne Paris Cité, Université Paris Descartes, Paris, France.

ABSTRACT

Background: Few studies have addressed the pragmatic management of ambulatory patients with suspected community-acquired pneumonia (CAP) using a precise description of the disease with or without chest X-ray (X-ray) evidence.

Aims: To describe the characteristics, clinical findings, additional investigations and disease progression in patients with suspected CAP managed by French General Practitioners (GPs).

Methods: The patients included were older than 18 years, with signs or symptoms suggestive of CAP associated with recent-onset unilateral crackles on auscultation or a new opacity on X-ray. They were followed for up to 6 weeks. Descriptive analyses of all patients and according to their management with X-rays were carried out.

Results: From September 2011 to July 2012, 886 patients have been consulted by 267 GPs. Among them, 278 (31%) were older than 65 years and 337 (38%) were at increased risk for invasive pneumococcal disease. At presentation, the three most common symptoms, cough (94%), fever (93%), and weakness or myalgia (81%), were all observed in 70% of patients. Unilateral crackles were observed in 77% of patients. Among patients with positive radiography (64%), 36% had no unilateral crackles. A CRB-65 score was obtained in 62% of patients. Most patients (94%) initially received antibiotics and experienced uncomplicated disease progression regardless of their management with X-rays. Finally, 7% of patients were hospitalised and 0.3% died.

Conclusions: Most patients consulting GPs for suspected CAP had the three following most common symptoms: cough, fever, and weakness or myalgia. More than a third of them were at increased risk for invasive pneumococcal disease. With or without X-rays, most patients received antibiotics and experienced uncomplicated disease progression.

Show MeSH
Related in: MedlinePlus