Pinto Frederico Ramos, Correia-Costa Liane, Azevedo Inês
Department of Physical Medicine and Rehabilitation, Centro Hospitalar Universitário São João, Alameda Professor Hernâni Monteiro, 4202-451 Porto, Portugal.
Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.
Hong Kong Physiother J. 2020 Dec;40(2):145-153. doi: 10.1142/S1013702520500146. Epub 2020 Aug 21.
Several respiratory scores have been created to evaluate bronchiolitis' severity level, but it is still not clear which is the best score. The aim of this study is to compare the Wang Respiratory Score (WRS) and the Kristjansson Respiratory Score (KRS) in the setting of an emergency room.
We performed a prospective observational study with 60 infants with bronchiolitis admitted to a paediatric emergency department. For both scores, we assessed inter-rater reliability between two different health professionals (physician and physiotherapist), internal consistency, and correlation with SpO testing the intraclass-correlation coefficient (ICC), weighted kappa, Cronbach coefficient and Spearman tests, respectively.
The inter-rater reliability was higher in KRS (ICC 0.79) and the Cronbach and weighted kappa had similar values in KRS versus WRS. The correlation between the KRS/WRS and SpO was poor/moderate upon admission and discharge for the first observer and the second observer.
While the internal consistency was similar in both scores, inter-rater reliability of KRS was higher than WRS, which allows us to conclude that it would have more consistent results when used to assess bronchiolitis' level of severity by health personnel in a busy hospital emergency room.
已创建多种呼吸评分来评估细支气管炎的严重程度,但仍不清楚哪种评分最佳。本研究的目的是在急诊室环境中比较王呼吸评分(WRS)和克里斯蒂安松呼吸评分(KRS)。
我们对60名入住儿科急诊科的细支气管炎婴儿进行了一项前瞻性观察研究。对于这两种评分,我们分别评估了两名不同卫生专业人员(医生和物理治疗师)之间的评分者间信度、内部一致性以及与经皮血氧饱和度(SpO)的相关性,分别采用组内相关系数(ICC)、加权kappa、克朗巴赫系数和斯皮尔曼检验。
KRS的评分者间信度更高(ICC 0.79),KRS与WRS的克朗巴赫系数和加权kappa值相似。对于第一位观察者和第二位观察者,入院时和出院时KRS/WRS与SpO之间的相关性较差/中等。
虽然两种评分的内部一致性相似,但KRS的评分者间信度高于WRS,这使我们得出结论,在繁忙的医院急诊室中,卫生人员使用KRS评估细支气管炎的严重程度时,其结果会更一致。