SciELO - Scientific Electronic Library Online

 
vol.34 issue3The Brazilian Portuguese version of the London Chest Activity of Daily Living scale for use in patients with chronic obstructive pulmonary diseaseNoncompliance with tuberculosis treatment involving self administration of treatment or the directly observed therapy, short-course strategy in a tuberculosis control program in the city of Carapicuíba, Brazil author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Jornal Brasileiro de Pneumologia

Print version ISSN 1806-3713

Abstract

SIGNORI, Leonardo Gilberto Haas et al. Sputum examination in the clinical management of community-acquired pneumonia. J. bras. pneumol. [online]. 2008, vol.34, n.3, pp. 152-158. ISSN 1806-3713.  http://dx.doi.org/10.1590/S1806-37132008000300005.

OBJECTIVE: To evaluate the frequency of the use of sputum examination in the clinical management of community-acquired pneumonia (CAP) in a general hospital and to determine whether its use has an impact on mortality. METHODS: The medical records of CAP patients treated as inpatients between May and November of 2004 at the Nossa Senhora da Conceição Hospital, located in Porto Alegre, Brazil, were reviewed regarding the following aspects: age; gender; severity of pneumonia (Fine score); presence of sputum; sputum bacteriology; treatment history; change in treatment; and mortality. RESULTS: A total of 274 CAP patients (134 males and 140 females) were evaluated. Using the Fine score to quantify severity, we classified 79 (28.8%) of those 274 patients as class II, 45 (16.4%) as class III, 97 (35.4%) as class IV, and 53 (19.3%) as class V. Sputum examination was carried out in 92 patients (33.6%). A valid sample was obtained in 37 cases (13.5%), and an etiological diagnosis was obtained in 26 (9.5%), resulting in a change of treatment in only 9 cases (3.3%). Overall mortality was 18.6%. Advanced age (above 65), CAP severity, and dry cough were associated with an increase in the mortality rate. Sputum examination did not alter any clinical outcome or have any influence on mortality. CONCLUSION: Sputum examination was used in a minority of patients and was not associated with any noticeable benefit in the clinical management of patients with CAP treated in a hospital setting.

Keywords : Pneumonia [etiology]; Sputum; Diagnosis.

        · abstract in Portuguese     · text in English | Portuguese     · pdf in English | Portuguese