Table 5.
Ability of clinical signs to identify pulmonary oedema in adults with severe malaria
| Clinical finding | Pulmonary oedema* | No pulmonary oedema |
PPV |
NPV |
Sensitivity |
Specificity |
|---|---|---|---|---|---|---|
| (95% CI) | (95% CI) | (95% CI) | (95% CI) | |||
| Crepitations on auscultation |
30/99 |
46/254 |
39% (28–51) |
75% (70–80) |
39% (21–40) |
82% (77–86) |
| Tachypnoea >20 breaths/min |
81/98 |
221/250 |
27% (22–32) |
63% (48–77) |
83% (74–90) |
12% (8–16) |
| Tachypnoea >30 breaths/min |
38/98 |
71/250 |
35% (26–45) |
75% (69–80) |
39% (29–49) |
72% (66–77) |
| Elevated JVP1# |
47/92 |
121/247 |
28% (21–35) |
74% (66–80) |
51% (40–62) |
51% (45–57) |
| Low JVP2# | 31/92 | 69/247 | 31% (22–41) | 74% (68–80) | 34% (24–44) | 72% (66–78) |
PPV Positive predictive value, NPV Negative predictive value.
* Extravascular lung water index ≥ 11 ml/kg (patients with concomitant aspiration pneumonia excluded).
1 JVP ≥5 cm above the sternal angle with the patient at 45º.
2 JVP < 3–4 cm above the sternal angle with the patient at 45º.
# JVP not visible in all patients.