Raised respiratory rate in elderly patients: a valuable physical sign

Measurements of respiratory rate in 82 long-stay patients aged 67-101 years yielded a normal range of 16-25 breaths a minute. In a prospective study of 60 consecutive acute admissions to a geriatric unit, 19 out of 21 patients diagnosed as lower respiratory tract infections had respiratory rates above the upper limit of normal on the day of diagnosis; the rise in respiratory rate preceded the clinical diagnosis. All eight patients who were diagnosed on admission as having a lower respiratory tract infection had a respiratory rate greater than 26, with a mean of 29.7 breaths a minute. Patients admitted for other conditions-for example, urinary tract infection-rarely had respiratory rates outside the normal range. Accurate measurement of respiratory rate is a valuable diagnostic aid in elderly patients.