OBSERVER AGREEMENT FOR RESPIRATORY SIGNS AND OXIMETRY IN INFANTS HOSPITALIZED WITH LOWER RESPIRATORY-INFECTIONS

被引:195
作者
WANG, EEL [1 ]
MILNER, RA [1 ]
NAVAS, L [1 ]
MAJ, H [1 ]
机构
[1] HOSP SICK CHILDREN,DIV INFECT DIS,TORONTO M5G 1X8,ONTARIO,CANADA
来源
AMERICAN REVIEW OF RESPIRATORY DISEASE | 1992年 / 145卷 / 01期
关键词
D O I
10.1164/ajrccm/145.1.106
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
To determine observer agreement for a clinical score and oximetry in lower respiratory infection in children less than 2 yr of age, a convenience sample of 56 infants hospitalized with bronchiolitis or pneumonia was assessed independently by two observers. A total of 12 infants had chronic lung disease of prematurity or congenital heart disease. Infants in whom oxygen supplementation could not be discontinued for at least 5 min were excluded. A severity score was assigned for each of four categories (respiratory rate, retractions, wheeze, and general appearance). A total for each patient was obtained by summing the score for each category. Oxygen saturation was measured using a Nellcor oximeter. Agreement beyond chance was measured using the kappa statistic. The relationship between observers for total score and oximetry and the mean total score and mean oximetry value for each patient was expressed as a Pearson correlation coefficient. A total of 56 infants and children were studied: 2 had pneumonia, 11 had an exacerbation of pulmonary signs and symptoms with their underlying cardiac or pulmonary disease, and 43 had bronchiolitis. Kappa was 0.48 for general assessment, 0.38 for respiratory rate, 0.31 for wheeze, and 0.25 for retractions. All values were statistically significantly greater than 0 at p < 0.01. Correlations for total score and for oximetry were 0.68 and 0.88, respectively. The median difference between oximetry readings was 1. The correlation coefficient between total score and oximetry was -0.04. The limited agreement for clinical signs makes comparison of patient illness severity between studies difficult. Furthermore, oximetry should be performed on all patients with lower respiratory distress to determine oxygen needs because there is a poor correlation between clinical findings and oximetry.
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页码:106 / 109
页数:4
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