Ogren J M
Memorial Hospital of Sandusky County, Fremont, Ohio 43420.
Am J Dis Child. 1990 Jan;144(1):109-11. doi: 10.1001/archpedi.1990.02150250121048.
Temperatures were measured using an electronic thermometer in an emergency department to determine the relationship between oral or rectal and axillary measurements. A total of 164 data pairs were obtained--95 in afebrile children, and 69 in febrile children. The correlation coefficient was .74 for oral-axillary pairs, and .70 for rectal-axillary pairs. The mean difference between oral and axillary temperatures was 1.17 degrees C +/- 0.72 degrees C, and between rectal and axillary temperatures was 1.81 degrees C +/- 0.97 degrees C. Using 37.4 degrees C (greater than or equal to 2 SDs) axillary as the upper limit of normal, the sensitivity, specificity, and positive and negative predictive values were calculated for detecting a fever. The sensitivity was 46%; specificity, 99%; positive predictive value, 97%; and negative predictive value, 72% for combined oral-axillary and rectal-axillary data. It was concluded that axillary temperatures are not sensitive enough to determine a fever when measured with an electronic thermometer. Electronic thermometers should be used to determine oral or rectal temperatures; axillary temperatures may be misleading and should be abandoned in the outpatient setting.
在急诊科使用电子温度计测量体温，以确定口腔或直肠温度与腋窝温度之间的关系。总共获得了164对数据——95对来自无发热儿童，69对来自发热儿童。口腔与腋窝温度对的相关系数为0.74，直肠与腋窝温度对的相关系数为0.70。口腔与腋窝温度的平均差值为1.17摄氏度±0.72摄氏度，直肠与腋窝温度的平均差值为1.81摄氏度±0.97摄氏度。以37.4摄氏度（大于或等于2个标准差）的腋窝温度作为正常上限，计算检测发热的敏感性、特异性、阳性预测值和阴性预测值。口腔与腋窝以及直肠与腋窝联合数据的敏感性为46%；特异性为99%；阳性预测值为97%；阴性预测值为72%。得出的结论是，使用电子温度计测量时，腋窝温度对确定发热不够敏感。应使用电子温度计来确定口腔或直肠温度；腋窝温度可能会产生误导，在门诊环境中应摒弃。
