دورية أكاديمية
Guideline adherence in febrile children below 3 months visiting European Emergency Departments: an observational multicenter study
| العنوان: | Guideline adherence in febrile children below 3 months visiting European Emergency Departments: an observational multicenter study |
|---|---|
| المؤلفون: | Tan, CD, Van der Walle, EEPL, Vermont, CL, Von Both, U, Carrol, ED, Eleftheriou, I, Emonts, M, Van der Flier, M, De Groot, R, Herberg, J, Kohlmaier, B, Levin, M, Lim, E, Maconochie, IK, Martinon-Torres, F, Nijman, RG, Pokorn, M, Rivero-Calle, I, Tsolia, M, Yeung, S, Zenz, W, Zavadska, D, Moll, HA, PERFORM consortium (Personalised Risk assessment in febrile children to optimize Real-life Management across the European Union) |
| المساهمون: | European Commission, National Institute of Health and Medical Research |
| بيانات النشر: | Springer |
| سنة النشر: | 2022 |
| المجموعة: | Imperial College London: Spiral |
| مصطلحات موضوعية: | Children, Emergency care, Fever, Guideline, Pediatrics, PERFORM consortium (Personalised Risk assessment in febrile children to optimize Real-life Management across the European Union), 1114 Paediatrics and Reproductive Medicine, 1117 Public Health and Health Services |
| جغرافية الموضوع: | Germany |
| الوصف: | Febrile children below 3 months have a higher risk of serious bacterial infections, which often leads to extensive diagnostics and treatment. There is practice variation in management due to differences in guidelines and their usage and adherence. We aimed to assess whether management in febrile children below 3 months attending European Emergency Departments (EDs) was according to the guidelines for fever. This study is part of the MOFICHE study, which is an observational multicenter study including routine data of febrile children (0-18 years) attending twelve EDs in eight European countries. In febrile children below 3 months (excluding bronchiolitis), we analyzed actual management compared to the guidelines for fever. Ten EDs applied the (adapted) NICE guideline, and two EDs applied local guidelines. Management included diagnostic tests, antibiotic treatment, and admission. We included 913 children with a median age of 1.7 months (IQR 1.0-2.3). Management per ED varied as follows: use of diagnostic tests 14-83%, antibiotic treatment 23-54%, admission 34-86%. Adherence to the guideline was 43% (374/868) for blood cultures, 29% (144/491) for lumbar punctures, 55% (270/492) for antibiotic prescriptions, and 67% (573/859) for admission. Full adherence to these four management components occurred in 15% (132/868, range 0-38%), partial adherence occurred in 56% (484/868, range 35-77%). CONCLUSION: There is large practice variation in management. The guideline adherence was limited, but highest for admission which implies a cautious approach. Future studies should focus on guideline revision including new biomarkers in order to optimize management in young febrile children. WHAT IS KNOWN: • Febrile children below 3 months have a higher risk of serious bacterial infections, which often leads to extensive diagnostics and treatment. • There is practice variation in management of young febrile children due to differences in guidelines and their usage and adherence. WHAT IS NEW: • Full guideline adherence is limited, ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 0340-6199 |
| العلاقة: | European Journal of Pediatrics; http://hdl.handle.net/10044/1/100064Test; Horizon 2020; CL-2018-21-007 |
| DOI: | 10.1007/s00431-022-04606-5 |
| الإتاحة: | https://doi.org/10.1007/s00431-022-04606-5Test http://hdl.handle.net/10044/1/100064Test |
| حقوق: | © The Author(s) 2022. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0Test/. ; http://creativecommons.org/licenses/by/4.0Test/ |
| رقم الانضمام: | edsbas.D7CF2B54 |
| قاعدة البيانات: | BASE |
| تدمد: | 03406199 |
|---|---|
| DOI: | 10.1007/s00431-022-04606-5 |