Benítez SE, Sánchez RD, Vega MV, Téllez PL, Pérez CAE

Language: Spanish
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ABSTRACT

Introduction: Pneumonia acquired in the community occupies the first place as a cause of death of infectious origin.
Objective: To analyze the predictive value of clinical elements suggestive of community-acquired pneumonia in patients with acute respiratory manifestations.
Method: Analytical study type case-control. Universe of 234 patients. Case group of 51 patients and control group of 101 individuals. Predictor variables: age, sex, neurological status, need for assistance, comorbidity, heart rate greater than 100, crackles, fever, data of typicality on interrogation; signs of pulmonary consolidation on the physical examination. The odd ratio was calculated with a 95% confidence interval. From the logistic regression a model was obtained, in which the positive predictive value, negative predictive value, sensitivity and specificity were included.
Results: Total assistance needs implied 5 times greater risk of being a carrier of pneumonia acquired in the community. The heart rate greater than 100 and fever greater than 38o presented the phenomenon of statistical colinearity. The presence of signs of parenchymal consolidation on physical examination predicted a 36-fold greater likelihood of pneumonia acquired in the community. The model obtained showed a sensitivity of 90% and specificity of 92%.
Conclusions: Clinical variables that showed the highest predictive value for the diagnosis of pneumonia were: altered neurological status, fever, heart rate greater than 100 beats per minute, and the presence of consolidation during the physical examination; with greater predictive meaning on the signs obtained during the physical examination of the thorax. The predictive model obtained from the logistic regression shows satisfactory efficiency parameters.