Anales espanoles de pediatria · 1996
[The usefulness of a clinical scoring system and pulse oximetry (SaO2) in assessing the severity of asthmatic crises].
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Luaces Cubells C, García García J J, Garrón Torrico P, Sánchez Mora M L, Camacho Díaz E
Аннотация
OBJECTIVE: To evaluate the ability of the Wood-Downes modified score (SPC) and the pulse oximetry to identify children with acute asthma who need hospitalization.
PATIENTS AND METHODS: One hundred twenty-one children were evaluated before (SPC-1, SaO2-1) and after (SPC-2, SaO2-2) nebulized salbutamol.
RESULTS: Nebulization with salbutamol improved both SPC and SaO2 (p < 0.001). A correlation was found between SPC-1 and SaO2-1 (r = -0.44, p < 0.001). The admitted patients differed significantly from the discharged ones in all four variables analyzed. No statistically significant difference was found to predict admission when a receiver operating characteristic curve was done between SPC-1 and SaO2-1. On the other hand, SPC-2 values predicted admission better than SaO2-2 (p < 0.0001). The cut-off points were considered to be: SPC-1 > or = 4; SaO2-1 < or = 91; SPC-2 > or = 2; and SaO2-2 < or = 96, with sensitivities of 60%, 47%, 100% and 47% and specificities of 76%, 92%, 69% and 84%, respectively.
CONCLUSIONS: 1. Both pulse oximetry and clinical SPC improved after treatment. 2. All four variables analyzed predict the need for hospitalization with no differences between SPC-1 and SaO2-1, with SPC-2 being better in predicting admission than SaO2-2.3. Pulse oximetry is an objective method, complementary to clinical judgement in deciding whether to hospitalize.
PATIENTS AND METHODS: One hundred twenty-one children were evaluated before (SPC-1, SaO2-1) and after (SPC-2, SaO2-2) nebulized salbutamol.
RESULTS: Nebulization with salbutamol improved both SPC and SaO2 (p < 0.001). A correlation was found between SPC-1 and SaO2-1 (r = -0.44, p < 0.001). The admitted patients differed significantly from the discharged ones in all four variables analyzed. No statistically significant difference was found to predict admission when a receiver operating characteristic curve was done between SPC-1 and SaO2-1. On the other hand, SPC-2 values predicted admission better than SaO2-2 (p < 0.0001). The cut-off points were considered to be: SPC-1 > or = 4; SaO2-1 < or = 91; SPC-2 > or = 2; and SaO2-2 < or = 96, with sensitivities of 60%, 47%, 100% and 47% and specificities of 76%, 92%, 69% and 84%, respectively.
CONCLUSIONS: 1. Both pulse oximetry and clinical SPC improved after treatment. 2. All four variables analyzed predict the need for hospitalization with no differences between SPC-1 and SaO2-1, with SPC-2 being better in predicting admission than SaO2-2.3. Pulse oximetry is an objective method, complementary to clinical judgement in deciding whether to hospitalize.