Resolution of symptoms in patients with community-acquired pneumonia treated on an ambulatory basis - 24/08/11

Doi : 10.1016/j.jinf.2003.11.013

Thomas J. Marrie ^a,⁎ , Michael D. Beecroft ^b, Zeljka Herman-Gnjidic ^b
^a Department of Medicine, 2F1.30 Walter C. Mackenzie Health Sciences Center, University of Alberta, 8440-112 Street, Edmonton, AB T6G 2B7, Canada
^b Bayer Inc., 77 Belfield Road, Toronto, Ont. M9W 1G6, Canada

Corresponding author. Tel.: +1-780-407-6234; fax: +1-780-407-3132

Abstract

Objective. To describe the resolution of five symptoms commonly associated with community-acquired pneumonia (CAP).

Methods. Three hundred and ninety-nine patients with CAP (Fine Classes I to III) recorded the severity (from 0 to 5) of fatigue, cough, dyspnoea, sputum, and pleuritic chest pain daily from enrollment to day 14 and also on days 30 and 42. A total symptom score was obtained by multiplying an individual score by four and summing the score of the five symptom (transformed score). A total symptom score of ≤20 or an individual symptom untransformed score of ≤1 was defined as resolution.

Results. The mean untransformed symptom scores at the time of presentation were: fatigue (3.5±1.4), cough (3.5±1.5), dyspnoea (2.7±1.5), sputum production (2.2±1.6) and chest pain (2.1±1.7). Sixty-seven percent had resolution of symptoms by day 14. When the study population was divided according to a mean total symptom score of ≤20 or >20 on day 14, the patients with a score >20 (n=122; 33%) had higher symptom scores at all time points out to 42 days. The median time to return to work was 6 days.

Conclusion. The pneumonia symptom severity score is a useful tool for advising patients regarding the time to symptomatic resolution of pneumonia.

Le texte complet de cet article est disponible en PDF.

Keywords : Pneumonia, Symptoms, Severity, Resolution, Cough, Sputum, Dyspnoea, Chest pain, Fatigue