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. 2025 Jan;64(1):83-90.
doi: 10.1177/00099228241254153. Epub 2024 May 17.

Community-Acquired Pneumonia Diagnosis Following Emergency Department Visits for Respiratory Illness

Alexandra T Geanacopoulos  1   2 , Janine P Amirault  1   2 , Kenneth A Michelson  3 , Michael C Monuteaux  1   2 , Susan C Lipsett  1   2 , Alexander W Hirsch  1   2 , Mark I Neuman  1   2
Affiliations

Community-Acquired Pneumonia Diagnosis Following Emergency Department Visits for Respiratory Illness

Alexandra T Geanacopoulos et al. Clin Pediatr (Phila). 2025 Jan.

Abstract

Community-acquired pneumonia (CAP) is often considered for children presenting to the emergency department (ED) with respiratory symptoms. It is unclear how often children are diagnosed with CAP following an ED visit for respiratory illness. We performed a retrospective case-control study to evaluate 7-day CAP diagnosis among children 3 months to 18 years discharged from the ED with respiratory illness from 2011 to 2021 and who receive care at 4 hospital-affiliated primary care clinics. Logistic regression was performed to assess for predictors of 7-day CAP diagnosis. Seventy-four (0.7%, 95% confidence interval [CI] = 0.6%, 0.9%) of 10 329 children were diagnosed with CAP within 7 days, and fever at the index visit was associated with increased odds of diagnosis (odds ratio [OR] = 3.32, 95% CI = 1.75-6.28). Community-acquired pneumonia diagnosis after discharge from the ED with respiratory illness is rare, even among children who are febrile at time of initial evaluation.

Keywords: diagnostic evaluation; emergency department; pneumonia; pneumonia risk factors; respiratory illness.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1:
Figure 1:
Study sample
Figure 2:
Figure 2:
Daily frequency of CAP diagnosis and cumulative CAP incidence among children discharged from the ED with respiratory illness. Bar graph depicts number of CAP cases by day after ED discharge. Line graph illustrates the cumulative CAP incidence among the full study cohort
See this image and copyright information in PMC

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