Table 2.
Clinical characteristics and investigations of patients admitted with acute lower respiratory tract disease over 21-day prospective review period in August to September 2020
| Characteristic | Pneumonia, n=152 (%) | NP-LRTI, n=188 (%) | Heart failure, n=77 (%) | All LRTD, n=410 (%) |
| GP | 56 (37) | 72 (39) | 30 (39) | 158 (39) |
| A&E department | 93 (61) | 100 (54) | 45 (58) | 238 (58) |
| Transfer from another unit | 2 (1) | 13 (7) | 0 (0) | 15 (4) |
| Other | 1 (1) | 1 (1) | 2 (3) | 4 (1) |
| Referral source | ||||
| Typical features* | 136 (89) | 163 (87) | 63 (82) | 355 (87) |
| Atypical features | 16 (11) | 25 (13) | 14 (18) | 55 (13) |
| Collapse/falls | 11 (7) | 12 (6) | 0 (0) | 23 (6) |
| Confusion | 0 (0) | 7 (4) | 4 (5) | 10 (2) |
| Drowsiness | 1 (1) | 1 (1) | 2 (3) | 4 (1) |
| Off legs/generally unwell | 5 (3) | 5 (3) | 8 (10) | 18 (4) |
| LRTD signs and symptoms on referral to AMU | ||||
| Biochemistry | 152 (100) | 185 (99) | 77 (100) | 419 (100) |
| Haematology | 152 (100) | 185 (99) | 77 (100) | 419 (100) |
| Radiology | 152 (100) | 185 (99) | 77 (100) | 419 (100) |
| Investigations performed | ||||
| Testing by age group | ||||
| All patients | 79/152 (52)† | 77/188 (41) | 11/77 (14) | 167 (41) |
| 18–24 | 3/4 (75) | 6/9 (66) | 0/0 (0) | 9/13 (69) |
| 25–34 | 0/0 (0) | 6/12 (50) | 0/0 (0) | 6/12 (50) |
| 35–44 | 5/6 (83) | 10/14 (71) | 2/2 (100) | 17/22 (77) |
| 45–54 | 6/8 (75) | 6/11 (55) | 0/0 (0) | 13/19 (68) |
| 55–64 | 11/18 (61) | 12/19 (63) | 5/8 (63) | 31/45 (69) |
| 65–74 | 15/34 (44) | 12/32 (38) | 1/10 (10) | 28/75 (37) |
| 75–84 | 21/43 (49) | 10/40 (25) | 2/20 (10) | 33/100 (33) |
| ≥85 | 18/39 (46) | 15/51 (19) | 1/37 (3) | 34/124 (27) |
| Test performed | ||||
| Blood culture | 79 (52) | 70 (37) | 5 (6) | 150 (37) |
| Urine culture | 66 (43) | 77 (41) | 11 (14) | 150 (37) |
| Sputum culture | 27 (18)† | 7 (4) | 2 (3) | 35 (9) |
| BinaxNOW Pn UAT | 29 (19)† | 6 (3) | 0 (0) | 35 (9) |
| Respiratory virus PCR | 16 (11)† | 11 (6) | 1 (1) | 28 (7) |
| Pleural fluid culture | 3 (2) | 0 (0) | 1 (1) | 4 (1) |
*Typical symptoms included cough, breathlessness, increased or discoloured sputum production, wheeze, pleurisy, peripheral oedema, haemoptysis, reduced exercise tolerance and/or fever.
†Ρ<0.05.
‡BinaxNOW Pn UAT was only performed in accordance with NICE/BTS guidelines.
A&E, accident and emergency department; AMU, acute medical unit; BTS, British Thoracic Society; GP, general practitioner; LRTD, lower respiratory tract disease; NICE, National Institute for Health and Care Excellence; NP-LRTI, non-pneumonic lower respiratory tract infection; Pn UAT, pneumococcal urinary antigen test.