title: The impact of an early chest radiograph on outcome in patients hospitalised with community-acquired pneumonia.
abstract: Patients admitted to UK hospitals with community-acquired pneumonia (CAP) require a chest radiograph for diagnostic purposes and to look for complications. This study investigated the association between a chest radiograph performed early in the process of care and clinical outcomes. Consecutive adults admitted with CAP to a large UK teaching hospital trust over a nine-month period were prospectively studied (n = 461). A time to first radiograph of < 4 hours was associated with a significantly shorter median length of hospital stay (LOS) compared with > or = 4 hours (5.75 days versus 7.13 days, p < 0.01). Antibiotics were administered after the radiograph in 89.8% of patients with a time to first radiograph < 4 hours compared with 40.7% of patients with time to first radiograph of > or = 4 hours (odds ratio 12.8, p < 0.001). A chest radiograph performed within four hours of hospital admission for CAP is significantly associated with a shorter hospital LOS and with antibiotic use after chest radiography.
authors.affiliation: Respiratory Medicine Department, Nottingham University Hospitals NHS Trust. thomasbewick@doctors.org.uk
authors.forename: Thomas
authors.initials: T
authors.lastname: Bewick
authors.forename: Sonia
authors.initials: S
authors.lastname: Greenwood
authors.forename: Wei Shen
authors.initials: WS
authors.lastname: Lim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000000981:diagnostic imaging*; D013902:Radiography, Thoracic; D015203:Reproducibility of Results; D012189:Retrospective Studies; D055815:Young Adult