The diagnosis of strep throat in adults in the emergency room.
The diagnosis of strep throat in adults in the emergency room.
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DOI：
10.1177/0272989x8100100304
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发表时间：
1981-01-01
期刊：
影响因子：
--
通讯作者：
Link, K
中科院分区：
文献类型：
--
作者：
Centor, R M;Witherspoon, J M;Link, K
到城市急诊室抱怨喉咙痛的成年患者都记录了培养和临床信息。采用logistic回归分析，构建了a群β链球菌培养阳性和居民猜测阳性的模型。阳性培养模型包括四个变量——扁桃体渗出物、宫颈前淋巴结肿胀、无咳嗽和发热史。所有4个变量的患者培养阳性的概率为56%；3个变量，32%；2个变量，15%；1个变量，6.5%；0个变量，2.5%住院医师的积极猜测模型显示了对身体检查的过度依赖和对病史的充分利用。阳性培养模型允许患者分层，以协助临床医生的管理策略。
Adult patients who presented to an urban emergency room complaining of a sore throat had cultures and clinical information recorded. Models were constructed, using logistic regression analysis, of both a positive culture for Group A beta streptococcus and a positive guess by a resident. The model of a positive culture consisted of four variables--tonsillar exudates, swollen tender anterior cervical nodes, lack of a cough, and history of fever. Patients with all 4 variables had a 56% probability of a positive culture; 3 variables, 32%; 2 variables, 15%; 1 variable, 6.5%; and 0 variables, 2.5%. The model of a positive guess by a resident demonstrated an over-reliance on physical exam and an underuse of history. The model of a positive culture allows stratification of patients to assist clinicians in the management strategies.