Development and validation of a prediction model for diagnosing blood stream infections in febrile, non-neutropenic children with cancer
| Autor: | Debra L. Friedman, Haerin Lee, M. Cecilia Di Pentima, Ayumi Shintani, Kelly L. Garcia, Robert B. Lindell, Monique E. Simpson, Zhiguo Zhao, Kathleen W. Montgomery, Karel G. M. Moons, Adam J. Esbenshade, Jennifer C. Esbenshade, Ato Wallace |
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| Rok vydání: | 2014 |
| Předmět: |
Pediatrics
medicine.medical_specialty business.industry medicine.medical_treatment Pediatric Hematology/Oncology Retrospective cohort study Hematology Odds ratio medicine.disease Peripherally inserted central catheter Oncology Internal medicine Pediatrics Perinatology and Child Health Absolute neutrophil count Medicine Chills medicine.symptom business Febrile neutropenia Central venous catheter |
| Zdroj: | Pediatric Blood & Cancer. 62:262-268 |
| ISSN: | 1545-5009 |
| DOI: | 10.1002/pbc.25275 |
| Popis: | Background Pediatric oncology patients are at increased risk for blood stream infections (BSI). Risk in the absence of severe neutropenia (absolute neutrophil count [ANC] ≥500/µl) is not well defined. Procedure In a retrospective cohort of febrile (temperature ≥38.0° for >1 hr or ≥38.3°) pediatric oncology patients with ANC ≥500/µl, a diagnostic prediction model for BSI was constructed using logistic regression modeling and the following candidate predictors: age, ANC, absolute monocyte count, body temperature, inpatient/outpatient presentation, sex, central venous catheter type, hypotension, chills, cancer diagnosis, stem cell transplant, upper respiratory symptoms, and exposure to cytarabine, anti-thymocyte globulin, or anti-GD2 antibody. The model was internally validated with bootstrapping methods. Results Among 932 febrile episodes in 463 patients, we identified 91 cases of BSI. Independently significant predictors for BSI were higher body temperature (Odds ratio [OR] 2.36 P |
| Databáze: | OpenAIRE |
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