دورية أكاديمية
Shock Index in the early assessment of febrile children at the emergency department: a prospective multicentre study
| العنوان: | Shock Index in the early assessment of febrile children at the emergency department: a prospective multicentre study |
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| المؤلفون: | Hagedoorn, NN, Zachariasse, JM, Borensztajn, D, Adriaansens, E, Von Both, U, Carrol, ED, Eleftheriou, I, Emonts, M, Van der Flier, M, De Groot, R, Herberg, JA, Kohlmaier, B, Lim, E, Maconochie, I, Martinón-Torres, F, Nijman, RG, Pokorn, M, Rivero-Calle, I, Tsolia, M, Zavadska, D, Zenz, W, Levin, M, Vermont, C, Moll, HA, PERFORM consortium |
| المساهمون: | National Institute of Health and Medical Research, European Commission |
| بيانات النشر: | BMJ Publishing Group |
| سنة النشر: | 2021 |
| المجموعة: | Imperial College London: Spiral |
| مصطلحات موضوعية: | epidemiology, physiology, PERFORM consortium, Pediatrics, 1103 Clinical Sciences, 1114 Paediatrics and Reproductive Medicine, 1117 Public Health and Health Services |
| جغرافية الموضوع: | England |
| الوصف: | OBJECTIVE: (1) To derive reference values for the Shock Index (heart rate/systolic blood pressure) based on a large emergency department (ED) population of febrile children and (2) to determine the diagnostic value of the Shock Index for serious illness in febrile children. DESIGN/SETTING: Observational study in 11 European EDs (2017-2018). PATIENTS: Febrile children with measured blood pressure. MAIN OUTCOME MEASURES: Serious bacterial infection (SBI), invasive bacterial infection (IBI), immediate life-saving interventions (ILSIs) and intensive care unit (ICU) admission. The association between high Shock Index (>95th centile) and each outcome was determined by logistic regression adjusted for age, sex, referral, comorbidity and temperature. Additionally, we calculated sensitivity, specificity and negative/positive likelihood ratios (LRs). RESULTS: Of 5622 children, 461 (8.2%) had SBI, 46 (0.8%) had IBI, 203 (3.6%) were treated with ILSI and 69 (1.2%) were ICU admitted. High Shock Index was associated with SBI (adjusted OR (aOR) 1.6 (95% CI 1.3 to 1.9)), ILSI (aOR 2.5 (95% CI 2.0 to 2.9)), ICU admission (aOR 2.2 (95% CI 1.4 to 2.9)) but not with IBI (aOR: 1.5 (95% CI 0.6 to 2.4)). For the different outcomes, sensitivity for high Shock Index ranged from 0.10 to 0.15, specificity ranged from 0.95 to 0.95, negative LRs ranged from 0.90 to 0.95 and positive LRs ranged from 1.8 to 2.8. CONCLUSIONS: High Shock Index is associated with serious illness in febrile children. However, its rule-out value is insufficient which suggests that the Shock Index is not valuable as a screening tool for all febrile children at the ED. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 0003-9888 |
| العلاقة: | 10044/1/90302; http://hdl.handle.net/10044/1/90302Test; Archives of Disease in Childhood; http://hdl.handle.net/10044/1/90305Test; CL-2018-21-007; Horizon 2020 |
| DOI: | 10.1136/archdischild-2020-320992 |
| الإتاحة: | https://doi.org/10.1136/archdischild-2020-320992Test http://hdl.handle.net/10044/1/90305Test |
| حقوق: | © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ThisTest is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0Test/. ; https://creativecommons.org/licenses/by/4.0Test |
| رقم الانضمام: | edsbas.66AC6ED1 |
| قاعدة البيانات: | BASE |
| تدمد: | 00039888 |
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| DOI: | 10.1136/archdischild-2020-320992 |