Skoner D P, Fischer T J, Gormley C, Martinez R, Bobbitt R C, Holroyde J
Ann Emerg Med. 1987 Jan;16(1):25-31. doi: 10.1016/s0196-0644(87)80280-9.
To develop a pediatric predictor index (PPI) for the outcome of emergency management of acute asthma, 156 children were studied prospectively and grouped by outcome. Of 193 episodes, 130 (67.4%) resulted in successful treatment, 39 (20.2%) in relapse, and 24 (12.4%) in admission. Measured and observed variables from before and after initial therapy were analyzed for the three groups. There were no significant differences between the relapse and successful treatment groups, which were combined for analysis and termed the discharge group. Significant differences were noted between the admission and discharge groups only for dyspnea before and after therapy, accessory muscle use, inspiratory breath sounds and wheezing, and post-respiratory rates, but not for pulse or peak expiratory flow rates before or after therapy. The PPI was determined with multivariate logistic regression and is calculated using the following variables: inspiratory breath sounds, wheezing, and respiratory rates. A score of 0 correctly categorized 95% of admissions, but incorrectly categorized 34% of those discharged. Despite low specificity and limited usefulness as early predictors of admission, PPI variables may serve as valuable adjuncts to the physician in determining the outcome of acute asthma in children.
为制定急性哮喘急诊治疗结局的儿科预测指数（PPI），对156名儿童进行了前瞻性研究，并根据结局进行分组。在193次发作中，130次（67.4%）治疗成功，39次（20.2%）复发，24次（12.4%）住院。分析了三组初始治疗前后测量和观察到的变量。复发组和治疗成功组之间无显著差异，将这两组合并进行分析并称为出院组。住院组和出院组之间仅在治疗前后的呼吸困难、辅助肌使用情况、吸气呼吸音和哮鸣音以及呼吸频率方面存在显著差异，而在治疗前后的脉搏或呼气峰值流速方面无显著差异。PPI通过多因素逻辑回归确定，并使用以下变量计算：吸气呼吸音、哮鸣音和呼吸频率。得分为0时，正确分类了95%的住院病例，但错误分类了34%的出院病例。尽管PPI作为住院早期预测指标的特异性较低且有用性有限，但PPI变量在确定儿童急性哮喘结局时可作为医生的重要辅助手段。
