The clinical respiratory score predicts paediatric critical care disposition in children with respiratory distress presenting to the emergency department

Autor: Asad Mian, Naureen Naseer, Owais Munir, Asher Feroze, Kanwal Nayani, Rubaba Naeem, Nick Brown
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
Clinical respiratory score (CRS)
medicine.medical_specialty
Critical Care
Paediatric emergency department
Intensive Care Units
Pediatric
Likelihood ratios in diagnostic testing
Severity of Illness Index
Pediatrics
03 medical and health sciences
0302 clinical medicine
Disease severity
Predictive Value of Tests
030225 pediatrics
medicine
Humans
Pakistan
030212 general & internal medicine
Respiratory system
Developing Countries
Respiratory distress
business.industry
lcsh:RJ1-570
Infant
Pediatrik
lcsh:Pediatrics
Paediatrics
Disposition
Emergency department
University hospital
Triage
Hospitalization
Paediatric respiratory distress
Low to middle income country (LMIC)
Child
Preschool
Pediatrics
Perinatology and Child Health
Emergency medicine
Female
Paediatric ICU
business
Emergency Service
Hospital
Respiratory Insufficiency
Research Article
Zdroj: BMC Pediatrics
BMC Pediatrics, Vol 18, Iss 1, Pp 1-8 (2018)
Popis: Background Respiratory distress is a common presenting complaint in children brought to the Emergency Department (ED). The Clinical Respiratory Score (CRS) has shown promise as a screen for severe illness in High Income Countries. We aimed to validate the admission CRS in children presenting to the ED of a Low-to Middle Income Country. Methods Children (1 month to 16 years) presenting with respiratory distress to the ED of the Aga Khan University Hospital, Karachi, Pakistan, between November 2015 to March 2016, were enrolled. The CRS was measured at initial presentation, prior to any management and 2 h after treatment was started. The predictive value for admission to the paediatric critical care units for a variety of cut offs for CRS at presentation were derived. Results A total of 112 children (70% male) of median age 12 months (IQR 2, 34.5 months) were enrolled. Patients with severe CRS (score 8–12) at presentation were more likely to be admitted to paediatric critical care (90% vs. 23% with mild-moderate CRS; OR: 5.7; 95% CI: 2.2–15.3, p 3 in predicting outcome were 94% (95% CI 79.8–99.3) and 40% (95% CI 35–45), respectively, with a positive likelihood ratio of 1.6 (95% CI 1.31–1.98) and negative predictive value of 94% (95% CI 81–98). Conclusion An admission CRS of > 3 in the ED of a Low-to Middle Income Country had excellent predictive value for disease severity, and it should be considered for incorporation into ED triage protocols.
Databáze: OpenAIRE
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