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Original ArticleOpen Access
Clinical Score and Arterial Oxygen Saturation in Children with Wheezing Associated Respiratory Dlness (W ARI)
Sritippayawan S 
,
Deerojanawong J ,
Prapphal N
,
Deerojanawong J ,
Prapphal N SUCHADA SRITIPPAYAWAN,M.D.*,
JITLADDA DEEROJANA WONG, M.D.*,
NUANCHAN PRAPPHAL, M.D.*
Objectives : To detennine the correlation between clinical score (based on respiratory
rate, chest wall retractions, air entry, wheezing, consciousness and audible wheezing) and arterial
oxygen saturation (Sa0
2
:
measured by pulse oximetry) as well as the most appropriate total score
for predicting hypoxemia (Sa0
2
~
95%) in children diagnosed to have wheezing associated res-
piratory illness (W ARI).
Subjects : 70 children ( 1 month -5 years old) hospitalized in the Department of
Pediatrics, Chulalongkorn Hospital with the diagnosis of W ARI from January
I,
1996 to Decem-
ber 31, 1996 were studied. Half of them were diagnosed to have acute lower respiratory tract
infection (LRI) with wheezing while the remainder had reactive airway disease (RAD).
Design : Cross sectional, analytical study
Methods : In each group of patients, the clinical score and Sa0
2
were assessed by the
same pediatrician throughout the study. The correlation between the clinical signs and Sa0
2
as
well as the cut off point of total score for predicting hypoxemia were analyzed. The
~ensitivity,
specificity and accuracy of that total score in predicting hypoxemia were also calculated.
Result : In both groups of patients (acute LRI with wheezing and RAD group), the
clinical signs correlated with Sa0
2
were wheezing (r,
=
-0.67 and -0.47 respectively) and chest wall
retractions (r
=
-0.57 and -0.59 respectively).Total score was also correlated with SaO, (r
=
-0.68 and -0.'5 respectively). The cut off point of total score in predicting hypoxemia was -4
p~oเธÂ
viding 80 per cent sensitivity in both groups with accuracy 74.3 per cent and 80 per cent res-
pectively.
Conclusion : This clinical score may be used to assess the severity of hypoxemia in
WARI patients. Wheezing, chest wall retractions and total score correlated well with SaO,. The
total score
>
4 was most appropriate in predicting hypoxemia in both children with RAD and
wheezing associated with LRI.
Key word : Clinical Score, Arterial Oxygen Saturation, W ARI, Children
JITLADDA DEEROJANA WONG, M.D.*,
NUANCHAN PRAPPHAL, M.D.*
Objectives : To detennine the correlation between clinical score (based on respiratory
rate, chest wall retractions, air entry, wheezing, consciousness and audible wheezing) and arterial
oxygen saturation (Sa0
2
:
measured by pulse oximetry) as well as the most appropriate total score
for predicting hypoxemia (Sa0
2
~
95%) in children diagnosed to have wheezing associated res-
piratory illness (W ARI).
Subjects : 70 children ( 1 month -5 years old) hospitalized in the Department of
Pediatrics, Chulalongkorn Hospital with the diagnosis of W ARI from January
I,
1996 to Decem-
ber 31, 1996 were studied. Half of them were diagnosed to have acute lower respiratory tract
infection (LRI) with wheezing while the remainder had reactive airway disease (RAD).
Design : Cross sectional, analytical study
Methods : In each group of patients, the clinical score and Sa0
2
were assessed by the
same pediatrician throughout the study. The correlation between the clinical signs and Sa0
2
as
well as the cut off point of total score for predicting hypoxemia were analyzed. The
~ensitivity,
specificity and accuracy of that total score in predicting hypoxemia were also calculated.
Result : In both groups of patients (acute LRI with wheezing and RAD group), the
clinical signs correlated with Sa0
2
were wheezing (r,
=
-0.67 and -0.47 respectively) and chest wall
retractions (r
=
-0.57 and -0.59 respectively).Total score was also correlated with SaO, (r
=
-0.68 and -0.'5 respectively). The cut off point of total score in predicting hypoxemia was -4
p~oเธÂ
viding 80 per cent sensitivity in both groups with accuracy 74.3 per cent and 80 per cent res-
pectively.
Conclusion : This clinical score may be used to assess the severity of hypoxemia in
WARI patients. Wheezing, chest wall retractions and total score correlated well with SaO,. The
total score
>
4 was most appropriate in predicting hypoxemia in both children with RAD and
wheezing associated with LRI.
Key word : Clinical Score, Arterial Oxygen Saturation, W ARI, Children
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