Abstract
Objectives
To assess the diagnostic value of the chest radiograph for the diagnosis of pneumonia
in bedridden patients, using non-contrast-enhanced high-resolution chest computed
tomography (CT) as the gold standard.
Methods
We prospectively evaluated bedridden patients hospitalized with moderate to high clinical
probability of pneumonia. Chest radiographs were interpreted in a blinded fashion
by 3 observers and classified as definite, normal, or uncertain for pneumonia. Chest
CT was obtained within 12 hours of chest radiograph. We applied Bayesian analysis
to assess the accuracy of chest radiograph in the diagnosis of pneumonia.
Results
In a 5-month period, 58 patients were evaluated, 31 (53%) were female. Their chest
radiographs were interpreted as negative, uncertain, or positive for pneumonia in
31 (53%), 15 (26%), and 12 (21%) patients, respectively, while CT confirmed pneumonia
in 11 (35%), 10 (67%), and in 10 (83%). The sensitivity of the chest radiograph to
diagnose pneumonia was 65%, the specificity was 93%, the positive and negative predictive
values were, respectively, 83% and 65%, while the overall accuracy was 69% (95% confidence
interval, 50%-79%).
Conclusions
In bedridden patients with suspected pneumonia, a normal chest radiograph does not
rule out the diagnosis, hence, a chest CT scan might provide valuable diagnostic information.
Keywords
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Article Info
Footnotes
Funding: Funded by the Research Fund of Shaare Zedek Medical Center, Jerusalem, Israel.
Conflict of Interest: No conflict of interest was relevant to the conduct of this study.
Authorship: All authors meet criteria for authorship and have seen and approved the article.
Identification
Copyright
© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Diagnostic Value of Chest Radiographs in Bedridden Patients with Suspected PneumoniaThe American Journal of MedicineVol. 123Issue 8
- PreviewWe read with great interest the article by Esayag et al1 regarding the diagnostic value of chest radiography for the diagnosis of pneumonia in bedridden patients. Few studies have provided an accurate estimation of chest radiography for the diagnosis of pneumonia, which is a particularly important issue in hospitalized patients. However, some key points are to be discussed.
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