Resolution of symptoms in patients with community-acquired pneumonia treated on an ambulatory basis
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 <or= 20 or an individual symptom untransformed score of <or= 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 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.
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 122 participants or records.
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