Clinical markers of serious illness in young infants: A multicentre follow-up study
| Autor: | F Jarman, G Silk, Zeffie Poulakis, J F Kerr, P. H. Hewson, D McMaster, J Goodge |
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| Rok vydání: | 2000 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Microbiological culture Critical Illness Digestive System Diseases Infections Sensitivity and Specificity Severity of Illness Index Infant Newborn Diseases Pallor Congenital Abnormalities Predictive Value of Tests Severity of illness medicine Humans business.industry Public health Infant Newborn Follow up studies Infant Reproducibility of Results Clinical trial El Niño Virus Diseases Predictive value of tests Pediatrics Perinatology and Child Health Female medicine.symptom business Biomarkers Follow-Up Studies |
| Zdroj: | Journal of Paediatrics and Child Health. 36:221-225 |
| ISSN: | 1440-1754 1034-4810 |
| DOI: | 10.1046/j.1440-1754.2000.00483.x |
| Popis: | Objective: To perform a multicentre follow-up study to determine if previously identified markers of serious illness in early infancy were robust and statistically reliable. Methods: Infants aged 1 week to 26 weeks presenting to the Emergency Departments of the Royal Children's Hospital and two Melbourne metropolitan hospitals were seen over a 12-month period. Eleven clinical markers as well as their temperature were documented by nursing staff and resident medical officers. Serious illness was defined if infants had a positive body fluid bacterial culture, a positive chest X-ray or if significant treatment was required in hospital. The predictive values, sensitivity and specificity for the individual and the best combination of clinical markers were determined. Results: Assessments (3806) were performed with 312 infants being assessed as seriously ill (8.2%). The combination of either drowsiness on history or examination, pallor on history or examination, breathing difficulty (chest wall recession), temperature above 38°C and a lump being present, identified 82.5% of all babies deemed subsequently to be seriously ill. The positive predictive value of an infant who was febrile, drowsy and pale on examination was 70.7% (previous study 74%). Conclusions: This study confirmed the high individual predictive value of arousal variables, pallor, and chest wall recession, especially when associated with fever, reaffirming their utility in the recognition of serious illness in infants under 6 months of age. |
| Databáze: | OpenAIRE |
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