The preschool respiratory assessment measure (PRAM): A responsive index of acute asthma severity
The preschool respiratory assessment measure (PRAM): A responsive index of acute asthma severity
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DOI：
10.1067/mpd.2000.110121
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发表时间：
2000-12-01
影响因子：
5.1
通讯作者：
Davis, GM
中科院分区：
文献类型：
--
作者：
Chalut, DS;Ducharme, FM;Davis, GM
目的：详细阐述和验证学前呼吸评估测量 (PRAM)，该测量可准确反映年轻哮喘患者气道阻塞的严重程度和对治疗的反应。 研究设计：对 217 名因急性哮喘到儿科急诊就诊的 3 至 6 岁儿童进行了一项前瞻性队列研究。通过强制振荡测量的呼吸阻力被视为金标准。儿童被随机分配到测试组（进行多变量分析以详细说明 PRAM）或验证组（测试 PRAM 的特征）。 结果：对于测试组 (N = 145)，最佳多变量模型包含 5 个变量：喘息、空气进入、斜角肌收缩、胸骨上回缩和氧饱和度。在验证组 (N = 72) 中，PRAM 与阻力变化显着相关 (r = 0.58)，但与支气管扩张之前 (r = 0.22) 和之后 (r = 0.36) 测量的预测阻力百分比略有相关。 3 的变化（95% CI：2.2，3.0）表明临床上存在重要变化。结论：PRAM 似乎是评估急性哮喘严重程度的一种反应灵敏但具有中等辨别力的工具。这项措施专为学龄前儿童设计，已针对肺功能的同步测量进行了验证。
Objective: To elaborate and validate a Preschool Respiratory Assessment Measure (PRAM) that would accurately reflect the severity of airway obstruction and the response to treatment in young patients with asthma.Study design: A prospective cohort study was performed in 217 children aged 3 to 6 years who presented to a pediatric emergency department with acute asthma. Respiratory resistance measured by forced oscillation sen ed as a gold standard. Children were randomized to either the test group, in which multivariate analyses were performed to elaborate the PRAM, or the validation group, in which the characteristics of the PRAM were tested.Results: For the test group (N = 145), the best multivariate model contained 5 variables: wheezing, air entry, contraction of scalenes, suprasternal retraction, and oxygen saturation. In the validation group (N = 72), the PRAM correlated substantially with the change in resistance (r = 0.58) but modestly with the % predicted resistance measured before (r = 0.22) and after bronchodilation (r = 0.36). A change of 3 (95% CI: 2.2, 3.0) indicated a clinically important change.Conclusions: PRAM appears to be a responsive but moderately discriminative tool for assessing acute asthma severity. This measure, designed for preschool-aged children, has been validated against a concurrent measure of lung function.