Pediatric Dyspnea Scale for use in hospitalized patients with asthma.
Pediatric Dyspnea Scale for use in hospitalized patients with asthma.
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DOI：
10.1016/j.jaci.2008.12.018
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发表时间：
2009-03
影响因子：
14.2
通讯作者：
Baptist, Alan P.
中科院分区：
文献类型：
--
作者：
Khan, Farah I.;Reddy, Raju C.;Baptist, Alan P.
哮喘是全国儿童住院的主要原因，但尚无临床工具可以将儿童对呼吸困难的感知纳入确定出院准备情况。我们试图开发小儿呼吸困难量表（PDS）来支持住院哮喘患者的出院决策，并将 PDS 与传统哮喘控制指标在预测出院后结果方面的表现进行比较。该研究纳入了因病情加重而住院的 6 至 18 岁哮喘儿童。出院时评估 PDS 评分、人口统计学、哮喘严重程度、肺量测定、呼气峰流速 (PEFR) 和呼出一氧化氮 (FENO)。出院 14 天后通过电话确定复发、活动限制、哮喘控制和哮喘相关的生活质量结果。共有 89 名受试者入组，其中 70 名完成了电话随访。 8 名患者病情复发，29 名患者抱怨活动受限。在 7 分制中，PDS 得分高于 2 分是这些不良结果的重要预测因素，PDS 每增加一分，风险就会加倍。 PDS 得分较高也与哮喘控制较差和哮喘特异性生活质量较差相关。在预测感兴趣的结果方面，PDS 的表现优于 FEV1、PEFR 或 FENO。 PDS 很容易在 6 岁儿童中使用，可能能够预测哮喘恶化住院后的不良后果，并且应该用作帮助指导住院患者出院决策的工具。
Asthma is a leading cause of pediatric hospitalizations across the country yet no clinical instrument exists that incorporates the child’s perception of dyspnea in determining discharge readiness. We sought to develop a Pediatric Dyspnea Scale (PDS) to support discharge decision-making in hospitalized asthmatic patients, and to compare the performance of PDS with traditional markers of asthma control in predicting outcomes after discharge. Asthmatic children aged 6 to 18 years hospitalized for an exacerbation were included in the study. The PDS score, demographics, asthma severity, spirometry, peak expiratory flow rate (PEFR) and exhaled nitric oxide (FENO) were assessed at the time of discharge. A telephone-call 14 days after discharge determined relapse, activity limitation, asthma control and asthma-related quality of life outcomes. Eighty-nine subjects were enrolled of whom 70 completed the phone follow-up. Eight patients had a relapse and 29 complained of limited activity. A PDS score above 2 on the 7-point scale was a significant predictor of these poor outcomes, with each additional point of the PDS doubling the risk. A higher score on PDS also correlated with worse asthma control and poor asthma-specific quality of life. The PDS performed better than FEV1, PEFR or FENO in predicting the outcomes of interest. The PDS, which is easy to use in children as young as 6 years of age, may be able to predict adverse outcomes after hospitalization for an asthma exacerbation, and should be used as a tool to help guide inpatient discharge decisions.
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DOI：
10.1164/rccm.200406-710st
发表时间：
2005-04-15
影响因子：
24.7
作者：
American Thoracic Society;European Respiratory Society
通讯作者：
European Respiratory Society
影响因子：
9.6
作者：
Grant, S;Aitchison, T;Dargie, H
通讯作者：
Dargie, H
影响因子：
9.6
作者：
KESTEN, S;MALEKIYAZDI, MR;REBUCK, AS
通讯作者：
REBUCK, AS
影响因子：
--
作者：
Newacheck, PW;Halfon, N
通讯作者：
Halfon, N
影响因子：
14.2
作者：
Strunk, RC;Szefler, SJ;Lemanske, RF
通讯作者：
Lemanske, RF