TABLE 4.
Criterion | Risk of Abnormality if Physical Exam Finding Present,a n/N (%) | Risk of Abnormality if Physical Exam Finding Absent,a n/N (%) | RR (95% CI) | Missing | Response of “Unsure,” “Don’t Know,” “Preverbal,” “Nonverbal,” or “Not Done” |
---|---|---|---|---|---|
General physical examination | |||||
Concerning skin findings (eg, café au lait) | 2/7 (28.6) | 38/347 (11.0) | 2.6 (0.8–8.7) | 0 | 0 |
Neurologic examinationb | |||||
Abnormal mental statusc | 10/62 (16.1) | 25/266 (9.4) | 1.7 (0.9–3.4) | 3 | 8 |
Abnormal overall neurologic exam other than mental status | 7/33 (21.2) | 26/291 (8.9) | 2.4 (1.2–5.0)** | 2 | 13 |
Any focal neurologic findings on exam (includes examination of pupil size, cranial nerves motor tone, motor strength, reflexes) | 5/16 (31.2) | 30/320 (9.4) | 3.3 (1.5–7.4)* | 3 | 0 |
Abnormal muscle tone (focal or diffuse) | 5/18 (27.8) | 30/317 (9.5) | 3.3 (1.3–6.7)* | 2 | 2 |
Abnormal motor strength (focal or diffuse) | 4/17 (23.5) | 28/307 (9.1) | 2.6 (1.0–6.5) | 2 | 13 |
Abnormal sensation (focal or bilateral) | 0/3 | 22/246 (8.9) | 0 | 3 | 87 |
Abnormal reflexes (focal or bilateral) | 1/11 (9.1) | 26/281 (9.3) | 1.0 (0.1–6.6) | 7 | 40 |
Abnormal gait | 0/7 | 13/195 (6.7) | 0 | 6 | 131 |
Abnormal cranial nerves (focal or bilateral) | 1/4 (25.0) | 28/290 (9.7) | 2.6 (0.5–14.7) | 4 | 41 |
Unequal pupil size | 2/5 (40.0) | 33/328 (10.1) | 4.0 (1.3–12.2) | 4 | 2 |
Abnormal posturing | 1/3 (33.3) | 28/314 (8.9) | 3.7 (0.7–19.2) | 19 | 3 |
Abnormal cerebellar functiond | 0/2 | 11/184 (6.0) | 0 | 1 | 42 |
Abnormal speechd | 0/6 | 14/196 (7.1) | 0 | 1 | 26 |
N = 354. *P < .05, **P = .05–0.10 (χ2 analysis). RR, relative risk.
Denominators exclude patients for whom a data point was missing or marked as “unsure,” “don’t know,” “preverbal,” “nonverbal,” or “unable to assess.”
Excludes 15 patients who were sedated, paralyzed, or intubated at the time of examination.
Mental status for the 328 patients with known mental status was collected as follows: 266 (81.1%) with normal mental status, 45 (13.7%) with mildly impaired mental status, and 17 (5.2%) with moderately/severely impaired mental status.
A priori excludes from all analysis patients either younger than 24 months or those sedated, paralyzed, or intubated at the time of examination (n = 125).