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Observational Study
. 2015 Mar 12:25:15010.
doi: 10.1038/npjpcrm.2015.10.

Suspected community-acquired pneumonia in an ambulatory setting (CAPA): a French prospective observational cohort study in general practice

Henri Partouche  1 , Céline Buffel du Vaure  1 , Virginie Personne  1 , Chloé Le Cossec  2 , Camille Garcin  2 , Alain Lorenzo  1 , Christian Ghasarossian  3 , Paul Landais  4 , Laurent Toubiana  5 , Serge Gilberg  1
Affiliations
Observational Study

Suspected community-acquired pneumonia in an ambulatory setting (CAPA): a French prospective observational cohort study in general practice

Henri Partouche et al. NPJ Prim Care Respir Med. .

Abstract

Background: Few studies have addressed the pragmatic management of ambulatory patients with suspected community-acquired pneumonia (CAP) using a precise description of the disease with or without chest X-ray (X-ray) evidence.

Aims: To describe the characteristics, clinical findings, additional investigations and disease progression in patients with suspected CAP managed by French General Practitioners (GPs).

Methods: The patients included were older than 18 years, with signs or symptoms suggestive of CAP associated with recent-onset unilateral crackles on auscultation or a new opacity on X-ray. They were followed for up to 6 weeks. Descriptive analyses of all patients and according to their management with X-rays were carried out.

Results: From September 2011 to July 2012, 886 patients have been consulted by 267 GPs. Among them, 278 (31%) were older than 65 years and 337 (38%) were at increased risk for invasive pneumococcal disease. At presentation, the three most common symptoms, cough (94%), fever (93%), and weakness or myalgia (81%), were all observed in 70% of patients. Unilateral crackles were observed in 77% of patients. Among patients with positive radiography (64%), 36% had no unilateral crackles. A null CRB-65 score was obtained in 62% of patients. Most patients (94%) initially received antibiotics and experienced uncomplicated disease progression regardless of their management with X-rays. Finally, 7% of patients were hospitalised and 0.3% died.

Conclusions: Most patients consulting GPs for suspected CAP had the three following most common symptoms: cough, fever, and weakness or myalgia. More than a third of them were at increased risk for invasive pneumococcal disease. With or without X-rays, most patients received antibiotics and experienced uncomplicated disease progression.

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Figures

Figure 1
Figure 1
Departmental distribution of investigators who participated in the CAPA study. CAPA, community-acquired pneumonia in an ambulatory setting; GP, general practitioner.
Figure 2
Figure 2
Flowchart of patients included. GP, general practitioner.
See this image and copyright information in PMC

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