Pulmonary radiographic findings and mortality in hospitalized patients with lower respiratory tract infections

Abstract 

Lower respiratory tract infections (LRTIs) remain a widespread problem and have a significant impact on primary healthcare resources. Previous studies have reported conflicting results on whether pulmonary radiographic findings at presentation predict lethality for patients with LRTIs.

The aim of this study was to determine if the pulmonary radiographic findings at the third day of hospitalisation were independently associated with lethality in patients with LRTIs.

A total of 616 patients with LRTIs, admitted to our hospital, were evaluated with regard to radiographic data. The prognostic analysis included an univariate approach of the following radiographic findings: focal alveolar infiltrates in one or more segments, focal alveolar infiltrates in one or more lobes, cavitations, diffuse infiltrates, solitary or multiple nodules, pleural effusion and fibrosis. Of the 616 patients, 560 patients (90.0%) had at least one pulmonary radiographic finding confirmed by a panel of radiologists. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) for Windows. Eleven independent radiographic variables were examined for association with lethality.

Overall lethality was 10.2% (553 survivors, 63 non-survivors). The only parameter found to be significantly different between survivors and non-survivors was cavitations on chest radiograph (p-value: 0.047).

In conclusion, the presence of cavitations on chest radiograph at third day of hospitalisation can help physicians' assessment of prognosis in patients with LRTIs, as it is an independent predictor of lethality.

Keywords: Lower respiratory tract infections (LRTIs), Chest radiograph, Hospitalisation, Lethality