Avaliação semiológica da palidez: concordância entre observadores e comparação com níveis séricos de hemoglobina

INTRODUCTION: Pallor is characterized by discoloring of the skin and mucous membranes due to a reduction in the amount of circulating hemoglobin. The objective of this study was to compare the degree of pallor, stratified using crosses, with hemoglobin levels and to evaluate the correlation between observers. METHOD: From February to April 2009, an observational cross-sectional study was carried out of over 18-year-old individuals admitted to a hospital in the south of the state of Santa Catarina, for whom the measurement of hemoglobin levels had been requested. The degree of Pallor (from absent to ++++/4) of the ocular mucosa of 96 patients was evaluated by two types of examiners (physicians and medical students). The Kappa agreement index was used to assess the agreement between observers. RESULTS: All patients (45.8% male and 54.2% female) were Caucasian with a mean age of 57.7 years. There were statistically significant differences on comparing the mean hemoglobin levels with pallor for the medical students but no significant differences were seen for the physicians. The Kappa agreement index between the observers was low. This research demonstrates that the agreement between the observers was not good for the evaluation of pallor. The most reliable evaluation regarding the hemoglobin levels was by the physicians.