Aged; Aged, 80 and over; Bias (Epidemiology); Female; Fever/diagnosis/etiology; Humans; Inpatients; Male; Prospective Studies; Rectum; Regression Analysis; Reproducibility of Results; Sensitivity and Specificity; Thermography/instrumentation/methods; Tympanic Membrane
Abstract :
[en] OBJECTIVES: To assess the agreement between infrared emission detection (IRED) ear and rectal temperatures and to determine the validity of IRED ear thermometry in detecting rectal fever. DESIGN: Prospective, convenience sample, unblinded study. SETTING: An acute geriatric unit (teaching hospital) and a multidisciplinary intensive care unit. PARTICIPANTS: The study included 45 inpatients (26 women and 19 men), aged 78.3+/-6.9 years, admitted over a 4-month period. Twelve of the patients were definitely infected. MEASUREMENTS: Sequential rectal (RT) and ear temperature (ET) measurements were performed using mercury-in-glass and IRED ear thermometers, respectively. IRED ear temperatures were measured at both ears (unadjusted mode), with the highest of six ear temperatures considered the true value. RESULTS: Mean RT (37.39 degrees C +/- 0.52 degrees C) was significantly (P<.001) higher than mean ET (36.89 degrees C +/-0.59 degrees C). A highly significant positive correlation was found between RT and ET (slope = 0.69; 95% CI, 0.52-0.86; P<.001; r = 0.78). The mean bias (mean of the differences) between RT and ET was 0.50 degrees C +/-0.37 degrees C (95% CI, 0.41 degrees C-0.59 degrees C), and the 95% limits of agreement -0.22 degrees C and 1.23 degrees C (95% CI, -0.38 degrees C to 1.39 degrees C). According to the standard criterion (RT > or =37.6 degrees C), 14 patients were febrile. Using an optimum IRED ear fever threshold (37.2 degrees C), the sensitivity and specificity of IRED ear thermometry for predicting rectal fever were 86% and 89%, respectively (positive predictive value, 80%; negative predictive value, 93%). CONCLUSIONS: The degree of agreement between rectal temperature and the highest of six IRED ear temperatures was acceptable. Using an optimal IRED ear fever threshold of 37.2 degrees C (99 degrees F), IRED ear thermometry had acceptable sensitivity and specificity for predicting rectal fever.
Disciplines :
General & internal medicine
Author, co-author :
Smitz, Simon ; Université de Liège - ULiège > Département des sciences de la santé publique > Ecole de santé publique
Giagoultsis, T
Dewé, Walthère ; Université de Liège - ULiège > Département des sciences cliniques > Médecine générale
Albert, Adelin ; Université de Liège - ULiège > Département des sciences de la santé publique > Informatique médicale et biostatistique
Language :
English
Title :
Comparison of rectal and infrared ear temperatures in older hospital inpatients.
Publication date :
2000
Journal title :
Journal of the American Geriatrics Society
ISSN :
0002-8614
eISSN :
1532-5415
Publisher :
Blackwell Science, Malden, United States - Massachusetts
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