氧饱和度作为急性哮喘儿童长期频繁使用支气管扩张剂治疗的预测指标。

Oxygen saturation as a predictor of prolonged, frequent bronchodilator therapy in children with acute asthma.

作者信息

Mehta Sanjay V, Parkin Patricia C, Stephens Derek, Keogh Kelly A, Schuh Suzanne

机构信息

Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Canada.

出版信息

J Pediatr. 2004 Nov;145(5):641-5. doi: 10.1016/j.jpeds.2004.06.072.

DOI:10.1016/j.jpeds.2004.06.072

PMID:15520765

Abstract

OBJECTIVES

To examine if the initial oxygen saturation (SaO2) in the Emergency Department is a useful predictor of prolonged frequent bronchodilator therapy (FBT) in children with acute asthma.

STUDY DESIGN

Prospective cohort study of 273 children, 1 to 17 years of age, requiring systemic corticosteroids. Patients were categorized as needing FBT for >4 hours (n=166) versus >4 hours (n=107) and >12 hours (n=79) versus >12 hours (n=194). Multiple logistic regression determined the association between SaO2 and these outcomes.

RESULTS

Baseline SaO2 remains a significant independent predictor of FBT for >4 hours (OR=0.81) and >12 hours (OR=0.84); 91% of patients with SaO2 of 90% to 91% had FBT >4 hours and 80% of patients with SaO2 of < or =89% had FBT >12 hours. Children with SaO2 of < or =91% are 14.7 and 12.0 times more likely to require FBT for >4 hours and >12 hours, respectively, than those with SaO2 of 98% to 100%. The interval likelihood ratios for FBT >4 hours were 12.3 for SaO2 of < or =89%, 6.5 for 90% to 91%, but only 1.8 for 92% to 93%. The likelihood ratios for FBT >12 hours decreased from 9.8 for SaO2 of < or =89% to 3.5 for SaO2 of 90% to 91%.

CONCLUSIONS

SaO2 is a useful predictor of FBT >4 hours if it is < or =91% and of FBT >12 hours if it is < or =89%.

摘要

目的

探讨急诊科初始血氧饱和度（SaO2）是否可作为急性哮喘患儿长期频繁使用支气管扩张剂治疗（FBT）的有效预测指标。

研究设计

对273名1至17岁需要全身使用皮质类固醇的儿童进行前瞻性队列研究。患者被分为需要FBT超过4小时（n = 166）与不超过4小时（n = 107），以及超过12小时（n = 79）与不超过12小时（n = 194）两组。多因素逻辑回归分析确定SaO2与这些结果之间的关联。

结果

基线SaO2仍然是FBT超过4小时（OR = 0.81）和超过12小时（OR = 0.84）的显著独立预测指标；SaO2为90%至91%的患者中有91%需要FBT超过4小时，而SaO2小于或等于89%的患者中有80%需要FBT超过12小时。与SaO2为98%至100%的儿童相比，SaO2小于或等于91%的儿童需要FBT超过4小时和超过12小时的可能性分别高出14.7倍和12.0倍。FBT超过4小时的区间似然比，SaO2小于或等于89%时为12.3，90%至91%时为6.5，但92%至93%时仅为1.8。FBT超过12小时的似然比从SaO2小于或等于89%时的9.8降至90%至91%时的3.5。