Identifying children with pneumonia in the emergency department
Identifying children with pneumonia in the emergency department
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DOI：
10.1177/000992280504400508
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发表时间：
2005-06-01
影响因子：
1.6
通讯作者：
Slap, GB
中科院分区：
文献类型：
--
作者：
Mahabee-Gittens, EM;Grupp-Phelan, J;Slap, GB
急诊医生需要在临床上区分有和没有肺炎放射学证据的儿童。在这项前瞻性队列研究中，510例年龄2 - 59个月的下呼吸道感染症状患者100%接受了胸部X线检查，44例（8.6%）胸部X线检查显示有肺炎。多因素分析显示，年龄大于12个月与临床表现显著相关的校正比值比（AOR）和95%可信区间（CI）（AOR 1.4，CI 1.1-1.9），RR 50或更高在12个月或以下的患者中，氧饱和度96%或更低（AOR 3.5，CI 1.6-7.5）和鼻张开（AOR 2.2，CI 1.2-4.0）。年龄大于12个月，RR 50或更大，血氧饱和度96%或更低，以及年龄小于12个月的儿童，鼻扩张，可以用于确定哪些具有下呼吸道感染症状的幼儿患有放射性肺炎。
Emergency physicians need to clinically differentiate children with and without radiographic evidence of pneumonia. In this prospective cohort study of 510 patients 2 to 59 months of age presenting with symptoms of lower respiratory tract infection, 100% were evaluated with chest radiography and 44 (8.6%) had pneumonia on chest radiography. With use of multivariate analysis, the adjusted odds ratio (AOR) and 95% confidence intervals (CI) of the clinical findings significantly associated with focal infiltrates were age older than 12 months (AOR 1.4, CI 1.1-1.9), RR 50 or greater (AOR 3.5, CI 1.6-7.5), oxygen saturation 96% or less (AOR 4.6, CI 2.3-9.2), and nasal flaring (AOR 2.2 CI 1.2-4.0) in patients 12 months of age or younger. The combination of age older than 12 months, RR 50 or greater, oxygen saturation 96% or less, and in children under age 12 months, nasal flaring, can be used in determining which young children with lower respiratory tract infection symptoms have radiographic pneumonia.