Prediction of pneumonia in outpatients with acute cough--a statistical approach

J Chronic Dis. 1984;37(3):215-25. doi: 10.1016/0021-9681(84)90149-8.


Cough is the fifth most common reason for physician visits, but data on acute cough have rarely been collected in a standardized manner and have not been analyzed in a multivariate fashion. We report data on 1819 patients presenting with cough, all of whom received a standardized history and physical, and a chest X-ray. Only 48 (2.6%) were found to have an acute radiographic infiltrate (pneumonia). The prevalence of common signs and symptoms is shown for the patients with and without pneumonia. Thirty-two of these findings were significant predictors of pneumonia (p less than 0.05, one-tailed). These 32 did not include some of the expected predictors of pneumonia and did include some predictors not previously described in the literature. A diagnostic rule is developed which identifies pneumonia patients with 91% sensitivity and 40% specificity, or 74% sensitivity and 70% specificity. The study results suggest that many pneumonias could be predicted based only on the patients histories. Physician visits to determine physical findings and chest X-rays might be avoided by telephone triage, with substantial cost savings.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Ambulatory Care*
  • Cough / diagnosis*
  • Cough / etiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Models, Biological
  • Pneumonia / complications
  • Pneumonia / diagnosis*
  • Pneumonia / diagnostic imaging
  • Radiography