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MEDISAN
On-line version ISSN 1029-3019
Abstract
ERNESTO PEREZ CALA, Armando et al. Deficiencies in the use of the clinical method for the classification of pneumonias acquired in the community. MEDISAN [online]. 2015, vol.19, n.4, pp. 492-502. ISSN 1029-3019.
A prospective, descriptive and longitudinal study of 62 patients with community-acquired pneumonias, admitted in "Dr. Joaquín Castillo Duany" Teaching Provincial Hospital in Santiago de Cuba was carried out from January to April, 2014, with the aim of identifying deficiencies in the use of the clinical method for an appropriate classification of these pneumonias. The results showed difficulties in the stages of the clinical method, as well as a shorter frequency of the description of the symptoms: fevers and abrupt chills, retrosternal pain and extrarrespiratory manifestations. Those patients affected referred no local changes of vocal vibrations, areas of parenchymatous dullness, tubal murmur and herpes labialis, and they really had these findings; besides, interstitial and even lobar infiltrates were also omitted in the thoracic x-rays. These deficiencies directly contributed to an inadequate identification of the pneumonias and a disproportionate lowering of the agreement rates between the diagnosis at admission and at discharge of the patients
Keywords : community-acquired pneumonias; clinical method; secondary health care.