Impact of parental and healthcare professional concern on the diagnosis of pediatric sepsis: a diagnostic accuracy study
ObjectiveThe Surviving Sepsis Campaign recommends systematic screening for sepsis. Although many sepsis screening tools include parent or healthcare professional concern, there remains a lack of evidence to support this practice. We aimed to test the diagnostic accuracy of parent and healthcare prof...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1140121/full |
| _version_ | 1797845561942999040 |
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| author | Zoe Sever Luregn J. Schlapbach Luregn J. Schlapbach Luregn J. Schlapbach Patricia Gilholm Melanie Jessup Natalie Phillips Natalie Phillips Shane George Shane George Shane George Kristen Gibbons Amanda Harley Amanda Harley Amanda Harley Amanda Harley |
| author_facet | Zoe Sever Luregn J. Schlapbach Luregn J. Schlapbach Luregn J. Schlapbach Patricia Gilholm Melanie Jessup Natalie Phillips Natalie Phillips Shane George Shane George Shane George Kristen Gibbons Amanda Harley Amanda Harley Amanda Harley Amanda Harley |
| author_sort | Zoe Sever |
| collection | DOAJ |
| description | ObjectiveThe Surviving Sepsis Campaign recommends systematic screening for sepsis. Although many sepsis screening tools include parent or healthcare professional concern, there remains a lack of evidence to support this practice. We aimed to test the diagnostic accuracy of parent and healthcare professional concern in relation to illness severity, to diagnose sepsis in children.DesignThis prospective multicenter study measured the level of concern for illness severity as perceived by the parent, treating nurse and doctor using a cross-sectional survey. The primary outcome was sepsis, defined as a pSOFA score >0. The unadjusted area under receiver-operating characteristic curves (AUC) and adjusted Odds Ratios (aOR) were calculated.SettingTwo specialised pediatric Emergency Departments in QueenslandPatientsChildren aged 30 days to 18 years old that were evaluated for sepsisInterventionNoneMain Results492 children were included in the study, of which 118 (23.9%) had sepsis. Parent concern was not associated with sepsis (AUC 0.53, 95% CI: 0.46–0.61, aOR: 1.18; 0.89–1.58) but was for PICU admission (OR: 1.88, 95% CI: 1.17–3.19) and bacterial infection (aOR: 1.47, 95% CI: 1.14–1.92). Healthcare professional concern was associated with sepsis in both unadjusted and adjusted models (nurses: AUC 0.57, 95% CI-0.50, 0.63, aOR: 1.29, 95% CI: 1.02–1.63; doctors: AUC 0.63, 95% CI: 0.55, 0.70, aOR: 1.61, 95% CI: 1.14–2.19).ConclusionsWhile our study does not support the broad use of parent or healthcare professional concern in isolation as a pediatric sepsis screening tool, measures of concern may be valuable as an adjunct in combination with other clinical data to support sepsis recognition.Clinical Trial RegistrationACTRN12620001340921. |
| first_indexed | 2024-04-09T17:41:02Z |
| format | Article |
| id | doaj.art-c1d65459fc46488194e4ba980c52ee71 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-04-09T17:41:02Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-c1d65459fc46488194e4ba980c52ee712023-04-17T05:48:48ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-04-011110.3389/fped.2023.11401211140121Impact of parental and healthcare professional concern on the diagnosis of pediatric sepsis: a diagnostic accuracy studyZoe Sever0Luregn J. Schlapbach1Luregn J. Schlapbach2Luregn J. Schlapbach3Patricia Gilholm4Melanie Jessup5Natalie Phillips6Natalie Phillips7Shane George8Shane George9Shane George10Kristen Gibbons11Amanda Harley12Amanda Harley13Amanda Harley14Amanda Harley15School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, QLD, AustraliaChild Health Research Centre, University of Queensland, South Brisbane, QLD, AustraliaPaediatric Intensive Care Unit, Queensland Children’s Hospital, Children's Health Queensland Hospital and Health Service, South Brisbane, QLD, AustraliaDepartment of Intensive Care and Neonatology, Children’s Research Center, University Children’s Hospital Zürich, Zürich, SwitzerlandChild Health Research Centre, University of Queensland, South Brisbane, QLD, AustraliaSchool of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, QLD, AustraliaChild Health Research Centre, University of Queensland, South Brisbane, QLD, AustraliaEmergency Department, Queensland Children’s Hospital, Children's Health Queensland Hospital and Health Service, South Brisbane, QLD, AustraliaChild Health Research Centre, University of Queensland, South Brisbane, QLD, AustraliaDepartments of Emergency Medicine and Children's Critical Care Service, Gold Coast University Hospital, Southport, QLD, AustraliaFaculty of Health, School of Medicine, and Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, AustraliaChild Health Research Centre, University of Queensland, South Brisbane, QLD, AustraliaSchool of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, QLD, AustraliaChild Health Research Centre, University of Queensland, South Brisbane, QLD, AustraliaDepartments of Emergency Medicine and Children's Critical Care Service, Gold Coast University Hospital, Southport, QLD, AustraliaCritical Care Nursing Management Team, Queensland Children’s Hospital, Brisbane, QLD, AustraliaObjectiveThe Surviving Sepsis Campaign recommends systematic screening for sepsis. Although many sepsis screening tools include parent or healthcare professional concern, there remains a lack of evidence to support this practice. We aimed to test the diagnostic accuracy of parent and healthcare professional concern in relation to illness severity, to diagnose sepsis in children.DesignThis prospective multicenter study measured the level of concern for illness severity as perceived by the parent, treating nurse and doctor using a cross-sectional survey. The primary outcome was sepsis, defined as a pSOFA score >0. The unadjusted area under receiver-operating characteristic curves (AUC) and adjusted Odds Ratios (aOR) were calculated.SettingTwo specialised pediatric Emergency Departments in QueenslandPatientsChildren aged 30 days to 18 years old that were evaluated for sepsisInterventionNoneMain Results492 children were included in the study, of which 118 (23.9%) had sepsis. Parent concern was not associated with sepsis (AUC 0.53, 95% CI: 0.46–0.61, aOR: 1.18; 0.89–1.58) but was for PICU admission (OR: 1.88, 95% CI: 1.17–3.19) and bacterial infection (aOR: 1.47, 95% CI: 1.14–1.92). Healthcare professional concern was associated with sepsis in both unadjusted and adjusted models (nurses: AUC 0.57, 95% CI-0.50, 0.63, aOR: 1.29, 95% CI: 1.02–1.63; doctors: AUC 0.63, 95% CI: 0.55, 0.70, aOR: 1.61, 95% CI: 1.14–2.19).ConclusionsWhile our study does not support the broad use of parent or healthcare professional concern in isolation as a pediatric sepsis screening tool, measures of concern may be valuable as an adjunct in combination with other clinical data to support sepsis recognition.Clinical Trial RegistrationACTRN12620001340921.https://www.frontiersin.org/articles/10.3389/fped.2023.1140121/fulldiagnosisconcerndoctornurseparentsepsis |
| spellingShingle | Zoe Sever Luregn J. Schlapbach Luregn J. Schlapbach Luregn J. Schlapbach Patricia Gilholm Melanie Jessup Natalie Phillips Natalie Phillips Shane George Shane George Shane George Kristen Gibbons Amanda Harley Amanda Harley Amanda Harley Amanda Harley Impact of parental and healthcare professional concern on the diagnosis of pediatric sepsis: a diagnostic accuracy study Frontiers in Pediatrics diagnosis concern doctor nurse parent sepsis |
| title | Impact of parental and healthcare professional concern on the diagnosis of pediatric sepsis: a diagnostic accuracy study |
| title_full | Impact of parental and healthcare professional concern on the diagnosis of pediatric sepsis: a diagnostic accuracy study |
| title_fullStr | Impact of parental and healthcare professional concern on the diagnosis of pediatric sepsis: a diagnostic accuracy study |
| title_full_unstemmed | Impact of parental and healthcare professional concern on the diagnosis of pediatric sepsis: a diagnostic accuracy study |
| title_short | Impact of parental and healthcare professional concern on the diagnosis of pediatric sepsis: a diagnostic accuracy study |
| title_sort | impact of parental and healthcare professional concern on the diagnosis of pediatric sepsis a diagnostic accuracy study |
| topic | diagnosis concern doctor nurse parent sepsis |
| url | https://www.frontiersin.org/articles/10.3389/fped.2023.1140121/full |
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