PT  - JOURNAL ARTICLE
AU  - Prendki, Virginie
AU  - Scheffler, Max
AU  - Huttner, Benedikt
AU  - Garin, Nicolas
AU  - Herrmann, François
AU  - Janssens, Jean-Paul
AU  - Marti, Christophe
AU  - Carballo, Sebastian
AU  - Roux, Xavier
AU  - Serratrice, Christine
AU  - Serratrice, Jacques
AU  - Agoritsas, Thomas
AU  - Becker, Christoph D.
AU  - Kaiser, Laurent
AU  - Rosset-Zufferey, Sarah
AU  - Soulier, Valérie
AU  - Perrier, Arnaud
AU  - Reny, Jean-Luc
AU  - Montet, Xavier
AU  - Stirnemann, Jérôme
TI  - Low-dose computed tomography for the diagnosis of pneumonia in elderly patients: a prospective, interventional cohort study
AID  - 10.1183/13993003.02375-2017
DP  - 2018 May 01
TA  - European Respiratory Journal
PG  - 1702375
VI  - 51
IP  - 5
4099  - http://erj.ersjournals.com/content/51/5/1702375.short
4100  - http://erj.ersjournals.com/content/51/5/1702375.full
SO  - Eur Respir J2018 May 01; 51
AB  - The diagnosis of pneumonia is challenging. Our objective was to assess whether low-dose computed tomography (LDCT) modified the probability of diagnosing pneumonia in elderly patients.We prospectively included patients aged over 65 years with a suspicion of pneumonia treated with antimicrobial therapy (AT). All patients had a chest radiograph and LDCT within 72 h of inclusion. The treating clinician assessed the probability of pneumonia before and after the LDCT scan using a Likert scale. An adjudication committee retrospectively rated the probability of pneumonia and was considered as the reference for diagnosis. The main outcome was the difference in the clinician's pneumonia probability estimates before and after LDCT and the proportion of modified diagnoses which matched the reference diagnosis (the net reclassification improvement (NRI)).A total of 200 patients with a median age of 84 years were included. After LDCT, the estimated probability of pneumonia changed in 90 patients (45%), of which 60 (30%) were downgraded and 30 (15%) were upgraded. The NRI was 8% (NRI event (−6%) + NRI non-event (14%)).LDCT modified the estimated probability of pneumonia in a substantial proportion of patients. It mostly helped to exclude a diagnosis of pneumonia and hence to reduce unnecessary AT.Low-dose CT modified the estimated probability of pneumonia in a substantial proportion (45%) of elderly patients http://ow.ly/V1ha30jvOMk