[Clinical predictors for the detection of community-acquired pneumonia in adults as a guide to ordering chest radiographs].

We sought to identify sensitive clinical predictors for the detection of community-acquired pneumonia in adults as a guide to the ordering of chest radiographs. The subjects were 79 outpatients with at least one clinical sign of fever, cough, sputum, chest pain, dyspnea and coarse crackle who underwent radiography of the chest to detect pneumonia. The relationship between these clinical signs and the presence of pneumonia was examined. Twenty-four patients (30.4%) had pneumonia. Twenty-two of these had 4 clinical signs: fever, cough, sputum and coarse crackle. Altogether, twenty-six of the 79 patients had these 4 clinical signs, and of them, 22 had pneumonia. Between the 4 clinical signs and the presence of pneumonia, the sensitivity was 91.7% and the specificity was 92.7%. On the basis of the above, as a diagnostic strategy, the ordering of chest radiographs to detect community-acquired pneumonia in adults was recommended when patients showed the 4 clinical signs of fever, cough, sputum and coarse crackle.