Interrater reliability and effect of state on blood pressure measurements in infants 1 to 3 years of age.

Full Abstract

OBJECTIVE:
The objective of this study was to determine the interrater variability and effect of state on systolic blood pressure measurements in infants </=3 years of age.

METHODS:
Study 1 examined interrater variability, determined by interclass correlation coefficient for 2 raters, and the effect of state on systolic blood pressure measurements in infants at 1, 2, and 3 years. Study 2 examined the variability of duplicate systolic blood pressure measurements by a single rater determined by interclass correlation coefficient and effect of state in 120 infants at 1, 2, and 3 years. Systolic blood pressure was defined as the Doppler-amplified sound corresponding to the first Korotkoff sound using a sphygmomanometer with appropriate cuff size. State was scored as follows:
1, sleeping; 2, awake and calm; 3, awake and fussy/restless; and 4, awake and vigorously crying/screaming.

RESULTS:
In study 1, the overall interclass correlation coefficient for systolic blood pressure was 0.81 and decreased when state varied between raters. When compared with a calm state 1 and/or 2 at both measurements, noncalm state 3 and/or 4 at both measurements was associated with an increase in systolic blood pressure. Although state was similar in infants born at </=36 and >36 weeks' gestational age, the former had a systolic blood pressure 13.0 +/- 14 mm Hg greater than the 50th centile for age and gender versus 2.4 +/- 12 mmHg for those >36 weeks' gestation. In study 2, the interclass correlation coefficient for repeated measurements by a single rater was 0.85, and noncalm state at both measurements was associated with an elevated systolic blood pressure.

CONCLUSIONS:
Systolic blood pressure can be accurately measured in the first 3 years after birth, but state modifies systolic blood pressure and must be determined at the time of measurement. Infants born at </=36 weeks' estimated gestational age may be at risk for an elevated systolic blood pressure, but this requires additional study.

Learn Faster Today Improve your study skills

Author information

Author/s: Duncan, Andrea F (AF); Rosenfeld, Charles R (CR); Morgan, Janet S (JS); Ahmad, Naveed (N); Heyne, Roy J (RJ);

Affiliation: UT Southwestern Medical Center, Department of Pediatrics, 5323 Harry Hines Blvd, Dallas, TX 75390-9063, USA.

Journal and publication information

Publication Type: Comparative Study; Journal Article

Journal: Pediatrics (Pediatrics), published in United States. (Language: eng)

Reference: 2008-Sep; vol 122 (issue 3) : pp e590-4

Dates: Created 2008/09/02; Completed 2008/09/16;

PMID: 18762493, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article (including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MESH Headings shown below.

These are the highest related articles currently in the database:

See 100+ related articles.