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Pneumonie - volwassenen
De berekening van de kans op pneumonie - volwassenen wordt gemaakt op basis van resultaten uit 15 betrouwbare studies. Het algoritme extraheert deze gegevens uit de database en berekent nakansen aan de hand van voorkansen en positieve en negatieve likelihoodratio's. De uitkomst van de berekening is uiteraard een statistische inschatting en onderhevig aan diverse onzekerheden. Lees over de belangrijke statistische tekortkomingen.

De gemiddelde voorkans in de gebruikte studies is 1.5 %

Inclusie criteria in gebruikte studies: All adults 

Anamnese

Koorts
Rillingen

Klinische tekens

Egofonie
Cyanosis
Demping bij percussie
Crepitaties
Pols > 100 / min
Verminderd vesiculair ademgeruis
SpO2 < 95%

Aanvullende onderzoeken

Long echografie
Rx thorax
CRP > 100 mg/l


Studies gebruikt in deze berekening

1.Moore M et al. Predictors of pneumonia in lower respiratory tract infections: 3C prospective cough complication cohort study. European Respiratory Journal 2017 50: 1700434
2.Holm A et al. Aetiology and prediction of pneumonia in lower respiratory tract infection in primary care. Br J Gen Pract. 2007 Jul 1; 57(540): 547–554
3.Heckerling PS et al. Clinical prediction rule for pulmonary infiltrates. Annals of Internal Medicine 1990 November 1, 113 (9): 664-70
4.Saldias PF et al. Predictive value of history and physical examination for the diagnosis of community-acquired pneumonia in adults. Rev Med Chil. 2007;135:143–150
5.Diehr P et al. Prediction of pneumonia in outpatients with acute cough–a statistical approach. J Chronic Dis. 1984;37:215–25
6.Melbye H et al. Diagnosis of pneumonia in adults in general practice. Relative importance of typical symptoms and abnormal chest signs evaluated against a radiographic reference stan- dard. Scand J Prim Health Care. 1992;10:226–33
7.Kern DG et al. Auscultated forced expiratory time as a clinical and epidemiologic test of airway obstruction. Chest. 1991;100:636–9
8.Gennis P et al. Clinical criteria for the detection of pneumonia in adults: guidelines for ordering chest roentgen- ograms in the emergency department. J Emerg Med. 1989;7:263–8
9.Laursen CB et al. Diagnostic performance of chest X-ray for the diagnosis of community acquired pneumonia in acute admitted patients with respiratory symptoms. Scand J Trauma Resusc Emerg Med. 2013; 21(Suppl 2): A21
10.Ticinesi A et al. Lung ultrasound and chest x-ray for detecting pneumonia in an acute geriatric ward. Medicine: July 2016 - Volume 95 - Issue 27 - p e4153
11.Nazerian P et al. Accuracy of lung ultrasound for the diagnosis of consolidations when compared to chest computed tomography. Am J Emerg Med. 2015 May;33(5):620-5
12.Bourcier JE et al. Performance comparison of lung ultrasound and chest x-ray for the diagnosis of pneumonia in the ED. American Journal of Emergency Medicine 32 (2014) 115–118
13.Xia Y et al. Effectiveness of lung ultrasonography for diagnosis of pneumonia in adults: a systematic review and meta-analysis. Journal Of Thoracic Disease, 8(10), 2822-2831
14.Le Bel J. Diagnostic accuracy of C-reactive protein and procalcitonin in suspected community-acquired pneumonia adults visiting emergency department and having a systematic thoracic CT scan. Crit Care. 2015; 19: 366
15.NICE clinical guideline: Pneumonia scope (September 2012)


Berekende kans

1.5 %