Clinical predictors for the detection of community-acquired pneumonia in adults as a guide to ordering chest radiographs

Objective: To identify sensitive clinical predictors for the detection of community-acquired pneumonia in adults as a guide to when to order a CXR. Methods: In total, 79 outpatients presenting with at least one of the following clinical features of pneumonia: fever, cough, sputum, chest pain, dyspnoea and coarse crackles and who underwent CXR to detect pneumonia were examined retrospectively. The relationship between these clinical features and the presence of pneumonia on CXR was determined. Results: A total of 24 patients (30.4%) had radiological evidence of pneumonia. In total, 22 presented with four clinical signs: fever, cough, sputum and coarse crackles. The sensitivity and the specificity of detecting pneumonia based on these four clinical signs mentioned was 91.7% and 92.7%, respectively. Conclusion: As a diagnostic strategy, the ordering of CXR to confirm a diagnosis of community-acquired pneumonia in adults is recommended when patients have the following four clinical signs: fever, cough, sputum and coarse crackles.