Prediction for serious bacterial infection in febrile children aged 3 years or younger: comparison of inflammatory markers, the Laboratory-score, and a new laboratory combined model
Purpose To compare the efficacy of inflammatory markers, the Laboratory-score, and a new laboratory combined model for predicting serious bacterial infection (SBI) in young febrile children. Methods The presence of SBI was reviewed in previously healthy children aged 3 years or younger with fever (&...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Pediatric Emergency Medicine
2019-12-01
|
| Series: | Pediatric Emergency Medicine Journal |
| Subjects: | |
| Online Access: | http://pemj.org/upload/pdf/pemj-2019-00080.pdf |
| _version_ | 1797852246411575296 |
|---|---|
| author | Yong-Won Kim Yeon-Young Kyong Kyung-Ho Choi Se-min Choi Young-Min Oh Joo-Suk Oh Sang-Hoon Oh Jung-Taek Park |
| author_facet | Yong-Won Kim Yeon-Young Kyong Kyung-Ho Choi Se-min Choi Young-Min Oh Joo-Suk Oh Sang-Hoon Oh Jung-Taek Park |
| author_sort | Yong-Won Kim |
| collection | DOAJ |
| description | Purpose To compare the efficacy of inflammatory markers, the Laboratory-score, and a new laboratory combined model for predicting serious bacterial infection (SBI) in young febrile children. Methods The presence of SBI was reviewed in previously healthy children aged 3 years or younger with fever (> 38℃) who visited the emergency department from 2017 through 2018. Areas under the curves (AUCs) of the receiver operating characteristic curve for SBI were compared with individual inflammatory markers (white blood cells [WBC] count, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], procalcitonin [PCT], and urine WBC count), the Laboratory-score, and a laboratory combined model. The latter model was developed using logistic regression analysis including ESR, CRP, and PCT. Results Of the 203 enrolled children, SBI was diagnosed in 58 (28.6%). For SBI prediction, the Laboratory-score showed 51.7% sensitivity (95% confidence interval [CI], 38.2%-65.0%) and 83.5% specificity (95% CI, 76.4%-89.1%). The AUC of the Laboratory-score (0.76) was significantly superior to the values of all individual inflammatory markers (WBC, 0.59 [P = 0.032]; ESR, 0.69; and CRP, 0.74 [P < 0.001]) except that of PCT (0.77, [P < 0.001]). The AUC of the laboratory combined model (0.80) was superior to that of the Laboratory-score (0.76) (P < 0.001). Conclusion In this study, the new laboratory combined model showed good predictability for SBI. This finding suggests the usefulness of combining ESR, CRP, and PCT in predicting SBI. |
| first_indexed | 2024-04-09T19:30:57Z |
| format | Article |
| id | doaj.art-5dae2c6f9906419b9a48ba8163aef55a |
| institution | Directory Open Access Journal |
| issn | 2383-4897 2508-5506 |
| language | English |
| last_indexed | 2024-04-09T19:30:57Z |
| publishDate | 2019-12-01 |
| publisher | Korean Society of Pediatric Emergency Medicine |
| record_format | Article |
| series | Pediatric Emergency Medicine Journal |
| spelling | doaj.art-5dae2c6f9906419b9a48ba8163aef55a2023-04-04T23:49:08ZengKorean Society of Pediatric Emergency MedicinePediatric Emergency Medicine Journal2383-48972508-55062019-12-0162424910.22470/pemj.2019.0008084Prediction for serious bacterial infection in febrile children aged 3 years or younger: comparison of inflammatory markers, the Laboratory-score, and a new laboratory combined modelYong-Won Kim0Yeon-Young Kyong1Kyung-Ho Choi2Se-min Choi3Young-Min Oh4Joo-Suk Oh5Sang-Hoon Oh6Jung-Taek Park7Department of Emergency Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, KoreaDepartment of Emergency Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, KoreaDepartment of Emergency Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, KoreaDepartment of Emergency Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, KoreaDepartment of Emergency Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, KoreaDepartment of Emergency Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, KoreaDepartment of Emergency Medicine, Seoul St. Mary's hospital, College of Medicine, The Catholic University of Korea, Seoul, KoreaDepartment of Emergency Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, KoreaPurpose To compare the efficacy of inflammatory markers, the Laboratory-score, and a new laboratory combined model for predicting serious bacterial infection (SBI) in young febrile children. Methods The presence of SBI was reviewed in previously healthy children aged 3 years or younger with fever (> 38℃) who visited the emergency department from 2017 through 2018. Areas under the curves (AUCs) of the receiver operating characteristic curve for SBI were compared with individual inflammatory markers (white blood cells [WBC] count, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], procalcitonin [PCT], and urine WBC count), the Laboratory-score, and a laboratory combined model. The latter model was developed using logistic regression analysis including ESR, CRP, and PCT. Results Of the 203 enrolled children, SBI was diagnosed in 58 (28.6%). For SBI prediction, the Laboratory-score showed 51.7% sensitivity (95% confidence interval [CI], 38.2%-65.0%) and 83.5% specificity (95% CI, 76.4%-89.1%). The AUC of the Laboratory-score (0.76) was significantly superior to the values of all individual inflammatory markers (WBC, 0.59 [P = 0.032]; ESR, 0.69; and CRP, 0.74 [P < 0.001]) except that of PCT (0.77, [P < 0.001]). The AUC of the laboratory combined model (0.80) was superior to that of the Laboratory-score (0.76) (P < 0.001). Conclusion In this study, the new laboratory combined model showed good predictability for SBI. This finding suggests the usefulness of combining ESR, CRP, and PCT in predicting SBI.http://pemj.org/upload/pdf/pemj-2019-00080.pdfbacterial infectionsemergency medicinefeverpediatricsprocalcitonin |
| spellingShingle | Yong-Won Kim Yeon-Young Kyong Kyung-Ho Choi Se-min Choi Young-Min Oh Joo-Suk Oh Sang-Hoon Oh Jung-Taek Park Prediction for serious bacterial infection in febrile children aged 3 years or younger: comparison of inflammatory markers, the Laboratory-score, and a new laboratory combined model Pediatric Emergency Medicine Journal bacterial infections emergency medicine fever pediatrics procalcitonin |
| title | Prediction for serious bacterial infection in febrile children aged 3 years or younger: comparison of inflammatory markers, the Laboratory-score, and a new laboratory combined model |
| title_full | Prediction for serious bacterial infection in febrile children aged 3 years or younger: comparison of inflammatory markers, the Laboratory-score, and a new laboratory combined model |
| title_fullStr | Prediction for serious bacterial infection in febrile children aged 3 years or younger: comparison of inflammatory markers, the Laboratory-score, and a new laboratory combined model |
| title_full_unstemmed | Prediction for serious bacterial infection in febrile children aged 3 years or younger: comparison of inflammatory markers, the Laboratory-score, and a new laboratory combined model |
| title_short | Prediction for serious bacterial infection in febrile children aged 3 years or younger: comparison of inflammatory markers, the Laboratory-score, and a new laboratory combined model |
| title_sort | prediction for serious bacterial infection in febrile children aged 3 years or younger comparison of inflammatory markers the laboratory score and a new laboratory combined model |
| topic | bacterial infections emergency medicine fever pediatrics procalcitonin |
| url | http://pemj.org/upload/pdf/pemj-2019-00080.pdf |
| work_keys_str_mv | AT yongwonkim predictionforseriousbacterialinfectioninfebrilechildrenaged3yearsoryoungercomparisonofinflammatorymarkersthelaboratoryscoreandanewlaboratorycombinedmodel AT yeonyoungkyong predictionforseriousbacterialinfectioninfebrilechildrenaged3yearsoryoungercomparisonofinflammatorymarkersthelaboratoryscoreandanewlaboratorycombinedmodel AT kyunghochoi predictionforseriousbacterialinfectioninfebrilechildrenaged3yearsoryoungercomparisonofinflammatorymarkersthelaboratoryscoreandanewlaboratorycombinedmodel AT seminchoi predictionforseriousbacterialinfectioninfebrilechildrenaged3yearsoryoungercomparisonofinflammatorymarkersthelaboratoryscoreandanewlaboratorycombinedmodel AT youngminoh predictionforseriousbacterialinfectioninfebrilechildrenaged3yearsoryoungercomparisonofinflammatorymarkersthelaboratoryscoreandanewlaboratorycombinedmodel AT joosukoh predictionforseriousbacterialinfectioninfebrilechildrenaged3yearsoryoungercomparisonofinflammatorymarkersthelaboratoryscoreandanewlaboratorycombinedmodel AT sanghoonoh predictionforseriousbacterialinfectioninfebrilechildrenaged3yearsoryoungercomparisonofinflammatorymarkersthelaboratoryscoreandanewlaboratorycombinedmodel AT jungtaekpark predictionforseriousbacterialinfectioninfebrilechildrenaged3yearsoryoungercomparisonofinflammatorymarkersthelaboratoryscoreandanewlaboratorycombinedmodel |