Ownby D R, Abarzua J, Anderson J A
Am J Dis Child. 1984 Nov;138(11):1062-6. doi: 10.1001/archpedi.1984.02140490062015.
If accurate predictions of outcome could be made, the emergency care of patients with asthma would be expedited. To evaluate how well initial peak flow determinations predicted hospitalization when used alone and when combined with other clinical variables, we prospectively studied 200 visits for the care of acute asthma. Using discriminant analysis, we selected the variables that best predicted discharge or admission for the first 100 cases. The best predictive variables were initial peak flow, history of treatment in preceding 24 hours, age at onset of asthma, and number of previous hospitalizations for asthma. This combination correctly predicted admission or discharge for 82% of the 200 cases. Despite this overall accuracy, admission was not well predicted. In the first 100 cases, only six of the 18 admissions were correctly predicted, and in the second 100 cases, none of the 15 admissions were correctly predicted, Initial peak flow measurements, even when combined with other variables, cannot predict hospitalization well enough to be substituted for a therapeutic trial.
如果能够对结果做出准确预测，哮喘患者的急诊护理将会加快。为了评估单独使用初始峰值流量测定以及将其与其他临床变量结合使用时，对住院情况的预测效果如何，我们对200例急性哮喘护理就诊病例进行了前瞻性研究。通过判别分析，我们为前100例病例选择了最能预测出院或入院的变量。最佳预测变量为初始峰值流量、前24小时的治疗史、哮喘发病年龄以及既往哮喘住院次数。这一组合正确预测了200例病例中82%的入院或出院情况。尽管总体准确率较高，但入院情况并未得到很好的预测。在前100例病例中，18例入院病例中只有6例被正确预测，在后100例病例中，15例入院病例无一被正确预测。初始峰值流量测量，即使与其他变量结合，也无法很好地预测住院情况，不足以替代治疗性试验。
