Acute lower respiratory tract infections

Symptoms, findings and management in Danish general practice

Line Slot Hansen, Jesper Lykkegaard, Janus Laust Thomsen, Malene Plejdrup Hansen

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Abstract

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.
Original languageEnglish
JournalEuropean Journal of General Practice
ISSN1381-4788
DOIs
Publication statusE-pub ahead of print - 25. Oct 2019

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General Practice
Delivery of Health Care
Lung
Chi-Square Distribution
Logistic Models
X-Rays

Cite this

@article{eb052c1eb5f741339cff9bdacfc33348,
title = "Acute lower respiratory tract infections: Symptoms, findings and management in Danish general practice",
abstract = "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.",
author = "{Slot Hansen}, Line and Jesper Lykkegaard and Thomsen, {Janus Laust} and {Plejdrup Hansen}, Malene",
year = "2019",
month = "10",
day = "25",
doi = "10.1080/13814788.2019.1674279",
language = "English",
journal = "European Journal of General Practice",
issn = "1381-4788",
publisher = "Taylor & Francis",

}

Acute lower respiratory tract infections : Symptoms, findings and management in Danish general practice. / Slot Hansen, Line; Lykkegaard, Jesper; Thomsen, Janus Laust; Plejdrup Hansen, Malene.

In: European Journal of General Practice, 25.10.2019.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Acute lower respiratory tract infections

T2 - Symptoms, findings and management in Danish general practice

AU - Slot Hansen, Line

AU - Lykkegaard, Jesper

AU - Thomsen, Janus Laust

AU - Plejdrup Hansen, Malene

PY - 2019/10/25

Y1 - 2019/10/25

N2 - 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.

AB - 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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JO - European Journal of General Practice

JF - European Journal of General Practice

SN - 1381-4788

ER -