Table 3

Risk Factors at First Consultation for Severe Adverse Outcomes (Death or Hospitalization From Lower Respiratory Tract Infection Complications Within 30 Days or Late Onset or Pneumonia Confirmed by X-ray or Reconsultation 8 to 30 Days After First Consultation) (n = 325)

Proportion of Patients Suffering Adverse OutcomeRisk RatioAdjusted Risk Ratioa
Characteristic + No. (%)Characteristic – No. (%)Ratio (95% CI)P ValueRatio (95% CI)P Value
Patient characteristics
Age ≥65 years163/7,921 (2.1)162/20,925 (0.8)2.66 (2.14-3.30)<0.0012.15 (1.72-2.67)<0.001
Male157/11,743 (1.3)16/17,098 (0.09)1.36 (1.10-1.70)0.0051.20 (0.96-1.50)0.112
Influenza vaccine152/9,842 (1.5)173/19,004 (0.9)170 (1.37-2.11)<0.0010.80 (0.61-1.05)0.110
Pneumovax <10 y95/5,294 (1.8)230/23,552 (1.0)1.84 (1.45-2.33)<0.0011.01 (0.79-1.29)0.939
Ever smoked1,997/15,165 (13.1)120/13,212 (0.9)1.43 (1.14-1.79)0.0021.25 (0.99-1.57)0.060
Any comorbidity210/13,100 (1.6)115/15,746 (0.7)2.19 (1.75-2.75)<0.0011.57 (1.24-1.99)<0.001
Lung comorbidity112/7,461 (1.5)213/21,385 (1.0)1.51 (1.20-1.89)<0.0011.00 (0.75-1.32)0.976
Steroids or bronchodilators93/6,537 (1.4)218/20,997 (1.0)1.37 (1.08-1.75)0.0100.87 (0.67-1.12)0.278
Living in deprived areab69/5,750 (1.2)256/23,096 (1.1)1.08 (0.83-1.41)0.5561.10 (0.81-1.50)0.530
Presenting symptoms
Shortness of breath246/18,498 (1.3)77/10,229 (0.8)1.77 (1.37-2.28)<0.0011.55 (1.18-2.04)0.002
Fever126/10,978 (1.1)198/17,800 (1.1)1.03 (0.83-1.29)0.7821.01 (0.80-1.29)0.919
Chills128/9,146 (1.4)195/19,621 (1.0)1.41 (1.13-1.76)0.0021.41 (1.11-1.79)0.005
Chest pain146/10,644 (1.4)178/18,130 (1.0)1.40 (1.12-1.74)0.0031.31 (1.03-1.67)0.028
Confusion25/1,860 (1.3)300/26,968 (1.1)1.21 (0.81-1.81)0.3601.11 (0.75-1.65)0.605
No coryza184/13,029 (1.4)139/15,718 (0.9)1.60 (1.28-1.99)<0.0011.60 (1.27-2.02)<0.001
Headache131/13,254 (1.0)193/15,507 (1.2)0.79 (0.64-0.99)0.0410.73 (0.57-0.94)0.014
Muscle aches112/10,497 (1.1)211/18,267 (1.2)0.92 (0.74-1.16)0.4950.82 (0.63-1.07)0.140
Diarrhea27/2,508 (1.1)298/26,312 (1.1)0.95 (0.64-1.41)0.8000.89 (0.60-1.31)0.557
Sputum: purulent186/18,221 (1.0)139/10,621 (1.3)0.78 (0.63-0.97)0.0260.70 (0.57-0.87)0.001
Sputum bloody or rusty16/1,023 (1.6)309/27,819 (1.1)1.19 (0.92-1.52)0.1790.99 (0.76-1.27)0.917
Clinical examination findings
Severity assessment >5/10198/11,893 (1.7)126/16,943 (0.7)2.24 (1.79-2.80)<0.0011.48 (1.13-1.93)0.004
Respiratory rate >24/min61/2,885 (2.1)263/25,844 (1.0)2.08 (1.58-2.74)<0.0011.42 (1.07-1.88)0.016
Temperature >37.8°C40/1,656 (2.4)28/27,169 (0.1)2.31 (1.67-3.21)<0.0011.82 (1.28-2.58)0.001
Pulse >100/min45/2,801 (1.6)280/26,033 (1.1)1.49 (1.09-2.04)0.0121.03 (0.75-1.40)0.858
O2 sat <95%60/1,698 (3.5)205/22,047 (0.9)3.80 (2.86-5.05)<0.0012.76 (2.08-3.65)<0.001
SBP<90 or DBP <60 mm Hg39/2,193 (1.8)286/26,653 (1.1)1.66 (1.19-2.31)0.0031.72 (1.20-2.46)0.003
Crackles1,922/12,256 (15.7)133/16,582 (0.8)1.95 (1.57-2.43)<0.0011.39 (1.01-1.90)0.044
Bronchial breathing37/2,166 (1.7)288/26,667 (1.1)1.58 (1.13-2.22)0.0081.07 (0.71-1.60)0.758
Wheezing107/7,071 (1.5)218/21,765 (1.0)1.51 (1.20-1.90)<0.0010.89 (0.67-1.18)0.412
  • O2 sat = oxygen saturation; SBP = systolic blood pressure; DBP = diastolic blood pressure.

  • a Adjusted by multivariable analysis for antibiotic prescribing, clustering, and other covariates in same category (ie, patient characteristics, presenting symptoms, or examinations findings, respectively).

  • b Living in area of England with deprivation index in top 10%.