Abstrato

Clinical profiling and outcomes of a fleeting diagnosis: Isolated right middle lobe pneumonia in the adult

S Cohen, S Lieberman, A Brom, A Biber, Y Sidi and G Segal

Background: Little is known about clinical profiling and outcomes of adults with Isolated Right Middle Lobe Pneumonia (iRMLP). No previous comparison was made between hospitalized patients with iRMLP and other types of pneumonia. Methods: We performed a retrospective analysis of patients with pneumonia during hospitalization. We checked the rate of iRMLP diagnosis by internal medicine physicians or a specialist in chest imaging. We performed a clinical profile of iRMLP patients, comparing their outcomes to other, non-iRMLP patients. We also checked the extent of diagnostic, interdiscipline, rate of diagnosis agreement. Results: 286 pneumonia patients were included, of which 16 (5.5%) were diagnosed as having iRMLP by a chest imaging specialist while 45 patients were diagnosed as having iRMLP by a specialist in internal medicine. The rate of agreement between assessments was fair (Cohen’s kappa coefficient=0.41). Overall 20 (7%) patients died during hospitalization. There was no correlation between the ascertained diagnosis of iRMLP and in-hospital mortality (p=0.3). 12 patients (4.2%) necessitated mechanical ventilation; 32 patients (11.2%) were re-hospitalized within 14 days and 37 patients (13%) died during the next 90 days. For 133 patients (46.5%) the Length of Hospitalization (LOS) was over 5 days and for 59 patients (20.6%) the LOS was longer than over 8 days. No outcome correlated with the ascertained diagnosis of iRMLP. Conclusion: iRMLP in the adult is a fleeting diagnosis which should rely on expert opinion. Clinical profiling and outcomes do not differ significantly between iRMLP and other hospitalized patients with pneumonia.