Sugishita Keiji, Saito Toshiaki, Asayama Yukino, Iwamoto Takashi
Kesennuma City Motoyoshi Municipal Hospital Kesennuma Miyagi Japan.
J Gen Fam Med. 2017 Jun 21;18(6):398-402. doi: 10.1002/jgf2.111. eCollection 2017 Dec.
Little is known about clinical factors associated with undetectable pneumonic shadows on chest radiographs (CRs) for diagnosing pneumonia in the primary care setting.
A retrospective assessment of CRs was conducted to compare chest computed tomography (CT) images of patients admitted to Kesennuma City Motoyoshi Municipal Hospital who were diagnosed with pneumonia from April 2014 to June 2016.
Eighty-three patients were included, and their average age was 83.8 years. Sixty-eight patients (81.9%) were officially certified as requiring long-term care or support. Twenty-nine of the 83 patients (34.9%) had either negative or normal findings on CRs, and positive findings consistent with pneumonia on CT. There were no significant differences in gender, age, cardiothoracic ratio on CR, or severity between the CR-negative and CR-positive groups. The proportion of negative CRs was significantly higher in patients with certified care level 5 under the long-term care system in Japan and tube feeding.
The failure rate of CRs for detecting pneumonic shadows was significantly higher in patients with certified care level 5 and tube feeding.
在基层医疗环境中，对于胸部X线片（CR）上肺炎阴影不可见的相关临床因素了解甚少，而CR常用于诊断肺炎。
对CR进行回顾性评估，以比较2014年4月至2016年6月在气仙沼市元吉市立医院被诊断为肺炎的患者的胸部计算机断层扫描（CT）图像。
纳入83例患者，平均年龄83.8岁。68例患者（81.9%）被正式认证为需要长期护理或支持。83例患者中有29例（34.9%）CR表现为阴性或正常，但CT显示与肺炎一致的阳性表现。CR阴性组和CR阳性组在性别、年龄、CR上的心胸比或严重程度方面无显著差异。在日本长期护理系统下被认证为护理级别5的患者和接受管饲的患者中，CR阴性的比例显著更高。
在被认证为护理级别5的患者和接受管饲的患者中，CR检测肺炎阴影的失败率显著更高。
