TY - JOUR
T1 - Identification of tachypnea and subcostal retractions as clinical signs for the diagnosis of Community-Acquired Pneumonia among children
T2 - Systematic review and meta-analysis
AU - Domecq, Juan Pablo
AU - Prutsky, Gabriela
AU - Lazo, María de los Ángeles
AU - Salazar, Carlos
AU - Montori, Víctor
AU - Prevost, Yolanda
AU - Huicho, Luis
AU - Erwin, Patricia
AU - Málaga, Germán
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2012
Y1 - 2012
N2 - Objectives. Determine whether tachypnea and subcostal retractions can be efficient predictors for the diagnosis of Community-Acquired Pneumonia (CAP) among children. Materials and methods. These were the databases used: PubMed, LILACS, The African Journal Database and The Cochrane Central Library. Original studies were included which assessed the diagnostic performance of the clinical criteria for tachypnea or subcostal retraction defined in accordance with the criteria of the World Health Organization (OMS) for CAP diagnosis in children ≤ 5 with cough and fever. The likelihood ratio (LR), the diagnosis odds ratio (DOR), and their respective confidence intervals at 95% (IC95%) were estimated for each clinical test. Results. 975 studies were found, eight were included in the review. 4740 patients were enrolled and 3584 (75%) were analyzed, 916 (19%) of which had a CAP diagnosis. When data were combined, tachypnea had a positive LR of 3.16, (95% CI 2.11-4.73) and a negative LR of 0.36 (95% CI 0.23-0.57). The DOR was 10.63 (95% CI 4.4-25.66, I2=93%). When subcostal retractions were analyzed, a positive LR of 2.49 (95%CI 1.41-4.37) and a negative LR of 0.59 (95%CI 0.4-0.87) were obtained. The DOR was 5.32 (95%CI 1.88-15.05, I2=89%). Conclusions. The presence or absence of tachypnea and subcostal retractions can be used in CAP diagnosis; it is worth considering the relative uncertainty in its diagnostic power and relatively modest LR. The confidence of these results is low due to the inadequate quality of the related evidence.
AB - Objectives. Determine whether tachypnea and subcostal retractions can be efficient predictors for the diagnosis of Community-Acquired Pneumonia (CAP) among children. Materials and methods. These were the databases used: PubMed, LILACS, The African Journal Database and The Cochrane Central Library. Original studies were included which assessed the diagnostic performance of the clinical criteria for tachypnea or subcostal retraction defined in accordance with the criteria of the World Health Organization (OMS) for CAP diagnosis in children ≤ 5 with cough and fever. The likelihood ratio (LR), the diagnosis odds ratio (DOR), and their respective confidence intervals at 95% (IC95%) were estimated for each clinical test. Results. 975 studies were found, eight were included in the review. 4740 patients were enrolled and 3584 (75%) were analyzed, 916 (19%) of which had a CAP diagnosis. When data were combined, tachypnea had a positive LR of 3.16, (95% CI 2.11-4.73) and a negative LR of 0.36 (95% CI 0.23-0.57). The DOR was 10.63 (95% CI 4.4-25.66, I2=93%). When subcostal retractions were analyzed, a positive LR of 2.49 (95%CI 1.41-4.37) and a negative LR of 0.59 (95%CI 0.4-0.87) were obtained. The DOR was 5.32 (95%CI 1.88-15.05, I2=89%). Conclusions. The presence or absence of tachypnea and subcostal retractions can be used in CAP diagnosis; it is worth considering the relative uncertainty in its diagnostic power and relatively modest LR. The confidence of these results is low due to the inadequate quality of the related evidence.
KW - Child
KW - Meta-analysis
KW - Pneumonia
KW - Respiratory rate
KW - Review
KW - Systematic
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U2 - 10.1590/S1726-46342012000300007
DO - 10.1590/S1726-46342012000300007
M3 - Review article
C2 - 23085794
AN - SCOPUS:84868089955
SN - 1726-4634
VL - 29
SP - 337
EP - 344
JO - Revista Peruana de Medicina Experimental y Salud Publica
JF - Revista Peruana de Medicina Experimental y Salud Publica
IS - 3
ER -