ABSTRACT
INTRODUCCIÓN: La bronquiolitis aguda (BA) es una enfermedad muy prevalente, con una elevada tasa de hospitalización estacional. Su manejo requiere de interpretaciones clínicas homogéneas, para lo cual existen diversas aproximaciones a través de escalas, ninguna de la cuales están validadas en la actualidad. OBJETIVO: Creación de una Escala de Severidad de la BA (ESBA) y su validación. MATERIAL Y MÉTODO: Elaboración de un constructo con parámetros graduales de puntuación acumulativa de la frecuencia respiratoria, frecuencia cardiaca, esfuerzo respiratorio, auscultación de sibilancias y crepitantes y relación inspiración/espiración. Validación de la ESBA sobre pacientes diagnosticados de BA; la fiabilidad medida a través de la observación del comportamiento de su consistencia interna, test-retest, validez externa y concordancia interobservadores. RESULTADOS: Sobre un total de 290 mediciones, se obtuvo una fiabilidad para un alfa de Cronbach del 0,784, índice de acuerdo Kappa del 0,93 en el test-retest y un índice de acuerdo Kappa del 0,682 (α<0,05) para la concordancia entre observadores. CONCLUSIONES: La ESBA puede ser un instrumento de fiable para medir la gravedad de la BA
INTRODUCTION: Acute bronchiolitis (AB) is a very common disease, with a high rate of seasonal hospitalization. Its management requires homogeneous clinical interpretations for which there are different approaches depending on the scales, none of which are properly validated today. OBJECTIVE: To create an AB severity scale (ABSS) and to validate it. MATERIAL AND METHOD: The development of a parameterized construct with a gradual cumulative score of respiratory rate, heart rate, respiratory effort, auscultation of wheezing and crackles, and the inspiration/expiration ratio. Also, the validation of the ABSS performed on patients diagnosed with AB, the reliability measured by observing the behavior of internal consistency, test-retest, external validity and inter-observer agreement. RESULTS: From a total of 290 measurements a Cronbach's reliability alpha of 0.83 was obtained; Kappa agreement index of 0.93 in the test-retest agreement, and Kappa index of 0.682 (α<0.05) for inter-observer agreement. CONCLUSIONS: The ABSS can be a reliable tool for measuring the severity of AB
Subject(s)
Humans , Male , Female , Child , Bronchiolitis/physiopathology , Severity of Illness Index , Acute Disease , Reproducibility of Results , Respiratory Function Tests/methods , Heart Function Tests/methodsABSTRACT
INTRODUCTION: Acute bronchiolitis (AB) is a very common disease, with a high rate of seasonal hospitalization. Its management requires homogeneous clinical interpretations for which there are different approaches depending on the scales, none of which are properly validated today. OBJECTIVE: To create an AB severity scale (ABSS) and to validate it. MATERIAL AND METHOD: The development of a parameterized construct with a gradual cumulative score of respiratory rate, heart rate, respiratory effort, auscultation of wheezing and crackles, and the inspiration/expiration ratio. Also, the validation of the ABSS performed on patients diagnosed with AB, the reliability measured by observing the behavior of internal consistency, test-retest, external validity and inter-observer agreement. RESULTS: From a total of 290 measurements a Cronbach's reliability alpha of 0.83 was obtained; Kappa agreement index of 0.93 in the test-retest agreement, and Kappa index of 0.682 (α<0.05) for inter-observer agreement. CONCLUSIONS: The ABSS can be a reliable tool for measuring the severity of AB.
Subject(s)
Bronchiolitis/diagnosis , Severity of Illness Index , Acute Disease , Diagnostic Techniques, Respiratory System/standards , Humans , Infant , Infant, Newborn , Reproducibility of ResultsSubject(s)
Hypocalcemia/etiology , Seizures/etiology , Female , Humans , Infant , Male , Pregnancy , Pregnancy Complications , Vitamin D DeficiencySubject(s)
Humans , Male , Female , Infant , Galactosemias/diagnosis , Galactosemias/pathology , Apraxias/diagnosis , Apraxias/pathology , Apraxias/therapy , Nervous System Diseases/epidemiology , Brain Diseases, Metabolic, Inborn/epidemiology , Galactosemias/complications , Galactosemias/prevention & control , Apraxias/complications , Apraxias/prevention & control , Brain Diseases, Metabolic, Inborn/complications , Brain Diseases, Metabolic, Inborn/diagnosis , Brain Diseases, Metabolic, Inborn/physiopathologyABSTRACT
Analysis of bronchial hyperresponsiveness using bronchial provocation tests are a key feature in the diagnosis of asthma, as well as a valid tool for monitoring disease severity, clinical course, and treatment response. We review non-specific bronchial challenge tests, including pharmacological stimuli (methacholine, adenosine) and physical stimuli (exercise, hypertonic saline, cold air hyperventilation). Although there is some correlation among responses to the distinct tests, individual responses are also observed. The indication for a single test will depend on whether the procedure will be used for diagnostic or epidemiologic purposes, and on experience of its use. Frequently, complementary information will be obtained. Indirect airway challenges tests such as physical stimuli and adenosine are more specific for asthma diagnosis.
Subject(s)
Asthma/diagnosis , Asthma/physiopathology , Bronchial Hyperreactivity/diagnosis , Bronchial Hyperreactivity/physiopathology , Bronchial Provocation Tests/methods , Patient Compliance , Child , Clinical Protocols , HumansABSTRACT
El análisis de la hiperrespuesta bronquial mediante pruebas de provocación bronquial es uno de los pilares fundamentales para el diagnóstico de asma, así como un instrumento válido para la monitorización de la enfermedad, valoración de su gravedad, su evolución y la respuesta al tratamiento. Revisamos las pruebas de provocación bronquial inespecíficas tanto por estímulos físicos (ejercicio físico, soluciones hiperosmolares, y la hiperventilación con aire frío) como por fármacos (metacolina y adenosina). Aunque hay una cierta correlación entre las respuestas a diferentes tipos de prueba, hay niños que responden de forma diferente. La elección de la prueba que hay que utilizar dependerá de los fines diagnósticos o epidemiológicos que persigamos, de la experiencia de su utilización, dándonos frecuentemente información complementaria. Las pruebas de provocación indirectas como los estímulos físicos y la adenosina son más específicas del asma
Analysis of bronchial hyperresponsiveness using bronchial provocation tests are a key feature in the diagnosis of asthma, as well as a valid tool for monitoring disease severity, clinical course, and treatment response. We review non-specific bronchial challenge tests, including pharmacological stimuli (methacholine, adenosine) and physical stimuli (exercise, hypertonic saline, cold air hyperventilation). Although there is some correlation among responses to the distinct tests, individual responses are also observed. The indication for a single test will depend on whether the procedure will be used for diagnostic or epidemiologic purposes, and on experience of its use. Frequently, complementary information will be obtained. Indirect airway challenges tests such as physical stimuli and adenosine are more specific for asthma diagnosis
