Durani Yamini, Friedman Marla J, Attia Magdy W
Division of Emergency Medicine, Department of Pediatrics, Alfred I. duPont Hospital for Children, Thomas Jefferson University, Wilmington, Delaware, USA.
Pediatr Int. 2008 Jun;50(3):352-5. doi: 10.1111/j.1442-200X.2008.02589.x.
The aim of this study was to develop a clinical prediction model that identifies respiratory syncytial virus (RSV) infection in infants and young children.
Children < or = 36 months of age with respiratory illness, who were suspected of having RSV infection, were enrolled in this prospective cohort study during the study period between January and February 2002. RSV testing was performed on all patients.
Of the 197 patients enrolled in the study, 126 (64%) were positive for RSV and 71 (36%) patients were either negative for RSV or had a positive culture for viruses other than RSV. The mean age of patients was 5 months and 57% were male. Backwards stepwise logistic regression analysis identified cough (p = 0.000), wheezing (p = 0.002), and retractions (p = 0.008) as independent variables predictive of RSV infection. The prediction model had a sensitivity of 80% (95% CI, 71-87%), specificity of 68% (95% CI, 54-79%), positive predictive value 82% (95% CI, 74-89%), negative predictive value 66% (95% CI, 52-77), positive likelihood ratio 2.5 (95% CI, 1.8-3.7) and post-test probability of 82%.
The combination of cough, wheezing and retractions predicts RSV infection in infants and young children.
本研究旨在开发一种临床预测模型，用于识别婴幼儿呼吸道合胞病毒（RSV）感染。
在2002年1月至2月的研究期间，将患有呼吸道疾病、疑似RSV感染的36个月及以下儿童纳入这项前瞻性队列研究。对所有患者进行RSV检测。
在纳入研究的197例患者中，126例（64%）RSV检测呈阳性，71例（36%）患者RSV检测呈阴性或培养出除RSV以外的其他病毒。患者的平均年龄为5个月，57%为男性。向后逐步逻辑回归分析确定咳嗽（p = 0.000）、喘息（p = 0.002）和吸气三凹征（p = 0.008）为预测RSV感染的独立变量。该预测模型的灵敏度为80%（95%CI，71 - 87%），特异度为68%（95%CI，54 - 79%），阳性预测值为82%（95%CI，74 - 89%），阴性预测值为66%（95%CI，52 - 77），阳性似然比为2.5（95%CI，1.8 - 3.7），检验后概率为82%。
咳嗽、喘息和吸气三凹征相结合可预测婴幼儿RSV感染。
