title: Sputum examination in the clinical management of community-acquired pneumonia.
abstract: OBJECTIVE
  To evaluate the frequency of the use of sputum examination in the clinical management of community-acquired pneumonia (CAP) in a general hospital and to determine whether its use has an impact on mortality.
  
  
  METHODS
  The medical records of CAP patients treated as inpatients between May and November of 2004 at the Nossa Senhora da Conceição Hospital, located in Porto Alegre, Brazil, were reviewed regarding the following aspects: age; gender; severity of pneumonia (Fine score); presence of sputum; sputum bacteriology; treatment history; change in treatment; and mortality.
  
  
  RESULTS
  A total of 274 CAP patients (134 males and 140 females) were evaluated. Using the Fine score to quantify severity, we classified 79 (28.8%) of those 274 patients as class II, 45 (16.4%) as class III, 97 (35.4%) as class IV, and 53 (19.3%) as class V. Sputum examination was carried out in 92 patients (33.6%). A valid sample was obtained in 37 cases (13.5%), and an etiological diagnosis was obtained in 26 (9.5%), resulting in a change of treatment in only 9 cases (3.3%). Overall mortality was 18.6%. Advanced age (above 65), CAP severity, and dry cough were associated with an increase in the mortality rate. Sputum examination did not alter any clinical outcome or have any influence on mortality.
  
  
  CONCLUSIONS
  Sputum examination was used in a minority of patients and was not associated with any noticeable benefit in the clinical management of patients with CAP treated in a hospital setting.
authors.affiliation: Federal Foundation School of Medical Sciences of Porto Alegre- Porto Alegre, Brazil.
authors.forename: Leonardo Gilberto Haas
authors.initials: LG
authors.lastname: Signori
authors.forename: Maurício Weyh
authors.initials: MW
authors.lastname: Ferreira
authors.forename: Luiz Carlos Hack Radünz
authors.initials: LC
authors.lastname: Vieira
authors.forename: Karen Reetz
authors.initials: KR
authors.lastname: Müller
authors.forename: Waldo Luís Leite Dias de
authors.initials: WL
authors.lastname: Mattos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D017064:Process Assessment, Health Care; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D013183:Sputum / Q000382:microbiology*; D015996:Survival Rate
chemical_list: D000900:Anti-Bacterial Agents