Specific Patterns of Postoperative Temperature Elevations Predict Blood Infection in Pediatric Burn Patients
| Autor: | Korkut Uygun, Martha Lydon, Maggie L. Dylewski, Jonah Poster, Chris Chu, Robert L. Sheridan, Joan M. Weber |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Fever Burn Units Scoring criteria Bacteremia Systemic inflammation 030207 dermatology & venereal diseases 03 medical and health sciences Postoperative Complications 0302 clinical medicine Predictive Value of Tests Internal medicine Humans Medicine Blood culture Stage (cooking) Child Retrospective Studies medicine.diagnostic_test business.industry Rehabilitation Significant difference Infant 030208 emergency & critical care medicine Retrospective cohort study Original Articles Predictive value of tests Emergency Medicine Surgery Pediatric burn medicine.symptom Burns business |
| Zdroj: | Journal of Burn Care & Research. 40:220-227 |
| ISSN: | 1559-0488 1559-047X |
| Popis: | Using readily available temperature data, we seek to propose a scoring criteria that can facilitate accurate and immediate prediction of blood infection. The standard in diagnosing blood infection is a positive blood culture result that may take up to 3 days to process, requiring providers to make a prediction about which febrile patient is actually bacteremic. This prediction is difficult in burned children as systemic inflammation can cause fever in the absence of infection. An ability to make this prediction more accurate using readily available information would be useful. A retrospective chart review was performed for 28 pediatric patients, with a burn size 20% or greater, admitted to the burn unit between 2010 and 2014. All children had blood cultures drawn. They were divided into either infection (positive blood cultures) or control (negative blood cultures) groups. Median temperature and mean number of temperature elevations were compared between the two groups. We evaluated the predictive accuracy of using temperature elevation, pattern, and timing to predict blood infection. A significant difference was seen in the mean number of temperature elevations above 39°C. This was significant for each time stage, especially in the 0- to 24-hour post-surgery period. We found the most predictive accuracy in the 0- to 12-, 12- to 38-, and 12- to 48-hour time periods. We found a strong association between mean number of fever spikes above 39°C and blood infection, especially 12 to 24 hours after surgery. This readily available data can be useful to clinicians as they access children with burns. |
| Databáze: | OpenAIRE |
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