Article
Diagnostic value of tachypnoea in pneumonia defined
radiologically
Miguel Palafox, Héctor Guiscafré, Hortensia Reyes, Onofre Muñoz, Homero Martínez
Research Unit on
Epidemiology and Health Services, Mexican Social Security Institute,
Centro Médico Nacional Siglo XXI, Unidad de Congresos, Bloque B, 4o.
Piso, Avenida Cuauhtémoc 330, Col. Doctores, Mexico 06725 DF
Correspondence to: Dr Martínez. e-mail: homero{at}solar.sar.net
Accepted 5 February
1999
OBJECTIVE
To evaluate
whether sensitivity and specificity of tachypnoea for the diagnosis of
pneumonia change with age, nutritional status, or duration of disease.
METHODSDiagnostic
testing of 110 children with acute respiratory infection, 51 of whom
presented with tachypnoea. The gold standard was a chest roentgenogram.
Thirty five children had a radiological image of pneumonia; 75 were
diagnosed as not having pneumonia. Sensitivity, specificity, and
percentage of correct classification of tachypnoea, by itself or in
combination with other clinical signs for all children, by age groups,
nutritional status, and disease duration were calculated.
RESULTSTachypnoea as
the sole clinical sign showed the highest sensitivity (74%) and a
specificity of 67%; 69% of cases were classified correctly.
Sensitivity was reduced when other clinical signs were combined with
tachypnoea, and there was no significant increase in correct
classification, although specificity increased to 84%. In children
with a disease duration of less than three days, tachypnoea had a lower
sensitivity and specificity (55% and 64%, respectively), and a lower
percentage of correct classification (62%). In children with low
weight for age (< 1 Z-score), tachypnoea had a sensitivity of 83%,
a specificity of 48%, and 60% correct classification. Sensitivity and
specificity did not vary with age groups.
CONCLUSIONSTachypnoea
used as the only clinical sign is useful for identifying pneumonia in
children, with no significant variations for age. In children with low
weight for age, tachypnoea had higher sensitivity, but lower
specificity. However, during the first three days of disease, the
sensitivity, specificity, and percentage of correct classification were
significantly lower.
Keywords: tachypnoea; pneumonia; sensitivity; specificity; diagnostic test
© 2000 by Archives of Disease in Childhood
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