Precisión de la taquipnea y las retracciones subcostales como signos clínicos para diagnóstico de neumonía adquirida en la comunidad en niños: Revisión sistemática y metaanálisis

Translated title of the contribution: Identification of tachypnea and subcostal retractions as clinical signs for the diagnosis of Community-Acquired Pneumonia among children: Systematic review and meta-analysis

Juan Pablo Domecq, Gabriela Prutsky, María de los Ángeles Lazo, Carlos Salazar, Víctor Montori, Yolanda Prevost, Luis Huicho, Patricia Erwin, Germán Málaga

Research output: Contribution to journalReview article

2 Scopus citations

Abstract

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.

Translated title of the contributionIdentification of tachypnea and subcostal retractions as clinical signs for the diagnosis of Community-Acquired Pneumonia among children: Systematic review and meta-analysis
Original languageSpanish
Pages (from-to)337-344
Number of pages8
JournalRevista Peruana de Medicina Experimental y Salud Publica
Volume29
Issue number3
DOIs
StatePublished - Jan 1 2012

Keywords

  • Child
  • Meta-analysis
  • Pneumonia
  • Respiratory rate
  • Review
  • Systematic

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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