Nolt et al used vital signs as an indication of underlying pneumonia in an adult with a respiratory infection with cough. The authors are from the VA Medical Center in Philadelphia, University of Pennsylvania, University of California in San Francisco and Massachusetts General Hospital.
Patient: adult (age >= 18) with respiratory infection and cough
Predictors of pneumonia:
(1) age > 50 years
(2) number of abnormal vital signs
Vital signs:
(1) temperature in °F
(2) pulse rate in beats per minute
(3) respiratory rate in breaths per minute
(4) oxygen saturation in percent
Parameter
Finding
Points
temperature
<= 100.4°F
0
> 100.4°F
1
pulse rate
<= 100 beats per minute
0
> 100 beats per minute
1
respiratory rate
<= 20 breaths per minute
0
> 20 breaths per minute
1
oxygen saturation
>= 95%
0
< 95%
1
number of abnormal vital signs =
= SUM(points for all 4 vital signs)
Interpretation:
• minimum number of abnormal vital signs: 0
• maximum number of abnormal vital signs: 4
Number of Abnormal Vital Signs
Percent with Pneumonia
0
4%
1
12%
2
20%
3
46%
4
69%
from Figure 1
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