What is the role of pulse oximetry in the assessment of patients with community-acquired pneumonia in primary care?

被引:18
作者
Bewick, Thomas [1 ]
Greenwood, Sonia [1 ]
Lim, Wei Shen [1 ]
机构
[1] City Hosp Nottingham, Dept Resp Med, Nottingham NG5 1PB, England
来源
PRIMARY CARE RESPIRATORY JOURNAL | 2010年 / 19卷 / 04期
关键词
Pneumonia; pulse oximetry; oxygenation; primary care; severity;
D O I
10.4104/pcrj.2010.00049
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Introduction: Community-acquired pneumonia (CAP) is a common presenting condition in primary care. Assessment of oxygenation status using pulse oximetry is increasingly available, but its precise role in disease severity assessment is unknown. Aims: To inform the use of pulse oximetry in patients with CAP, including the utility of different oxygenation thresholds, patient subgroups, and interaction with existing severity scores. Methods: A prospective cohort study of adults with CAP admitted to a UK teaching hospital trust. Oxygen saturations (SpO2) and the fraction of inspired oxygen were recorded on admission. The value of different SpO2 thresholds (<88%, <= 90%, <= 92%, and <95%) in predicting 30-day mortality and critical care admission was analysed. Results: 467 patients had SpO2 measured on room air. Admission SpO2 <= 90% was observed in 28% of patients and had reasonable specificity (76%) for 30-day mortality or critical care admission, but low sensitivity (46%). Specificity was particularly good for adults <50 years of age (90%) or those with asthma (92.3%). Conclusions: SpO2 <= 90% has good specificity but low sensitivity for adverse outcomes in CAR It complements rather than replaces clinical severity scoring. (c) 2010 Primary Care Respiratory Society UK. All rights reserved. T Bewick et al. Prim Care Resp J 2010; 19(4): 378-382 doi:10.4104/pcrj.2010.00049
引用
收藏
页码:378 / 382
页数:5
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