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Utility of Pulse Oximetry in Diagnosing Pneumonia in Nursing Home Residents
Journal article   Peer reviewed

Utility of Pulse Oximetry in Diagnosing Pneumonia in Nursing Home Residents

Keith S. Kaye, Malini Stalam, Wendy E. Shershen and Donald Kaye
The American journal of the medical sciences, v 324(5), pp 237-242
Nov 2002
DOI: https://doi.org/10.1097/00000441-200211000-00001
PMID: 12449443
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Diagnosis Nursing home Oxygen saturation Pneumonia Vital signs
The differential diagnosis of acute infection in elderly nursing home patients is often difficult. This study evaluated pulse oximetry in pneumonia in this population. A case-control study was performed in a veteran’s nursing home involving 2 analyses: (1) pneumonia patients (case subjects) were compared with patients with nonpulmonary infections (control subjects) at time of acute infection; (2) differences in paired values measured at time of infection versus a noninfected baseline were compared for pneumonia patients and control subjects. Vital signs including pulse oximetry were obtained routinely (at least monthly) and with acute illness. Oxygen saturations were lower in 45 pneumonia patients than in 22 patients with acute nonpulmonary infections (P < 0.001). An oxygen saturation < 94 gave a sensitivity for pneumonia of 80%, specificity of 91%, and positive predictive value of 95%. The drop in oxygen saturation from the last baseline value was greater in pneumonia patients than in control subjects (P < 0.001). The sensitivity of an oxygen saturation drop >3% from baseline for pneumonia was 73% with specificity and positive predictive values of 100%. Pulse oximetry may be very helpful in evaluating acutely infected nursing home residents. The present study suggests that in acutely infected nursing home patients, a decrease in oxygen saturation of >3 % from baseline, as well as a single oxygen saturation of <94, should suggest pneumonia. A decrease from baseline of <4 % or a single oxygen saturation of 94 or higher suggests that pneumonia is unlikely.

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23 citations in Web of Science
31 citations in Scopus

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Collaboration types
Domestic collaboration
Web of Science research areas
Infectious Diseases
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