Trends in C-Reactive Protein testing: a retrospective cohort study in paediatric ambulatory care settings
<p><strong>Objectives</strong> This study aims to investigate CRP testing practices in paediatric ambulatory care across British primary care and accident and emergency (A&E) departments.</p> <br> <p><strong>Design, Setting, Participants:</strong>...
| Main Authors: | , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
BMJ Publishing Group
2024
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| _version_ | 1811139718434258944 |
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| author | Alkhmees, M Van den Bruel, A Hayward, G Blanker, MH Walker, AS Holtman, G |
| author_facet | Alkhmees, M Van den Bruel, A Hayward, G Blanker, MH Walker, AS Holtman, G |
| author_sort | Alkhmees, M |
| collection | OXFORD |
| description | <p><strong>Objectives</strong> This study aims to investigate CRP testing practices in paediatric ambulatory care across British primary care and accident and emergency (A&E) departments.</p>
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<p><strong>Design, Setting, Participants:</strong> This retrospective cohort study included children <18 years old having ≥1 CRP test at primary care or A&E departments in Oxfordshire between 2007-2021.</p>
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<p><Strong>Outcomes:</strong> We estimated the frequency and annual changes in CRP testing in both settings, and evaluated referral and admission patterns based on CRP levels: low (<20 mg/L), intermediate, or high (≥80 mg/L).</p>
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<p><strong>Results</strong> Over 15 years, 91,540 CRP tests were requested in 63,226 children, with 33,882 (53.6%) in primary care and 29,344 (46.4%) in A&E. Both settings showed rising trends in test requests, with average annual percentage change of 3.0% (95% CI 1.2 to 4.7) in primary care and 11.5% (95% CI 8.6 to 14.6) in A&E. The proportion of intermediate/high-test results remained stable. In primary care, 50,709 (95.8%) of tests were <20 mg/L, with 99.0% of these children managed at home. High and intermediate CRP values increased odds of referral versus low CRP (Odds ratio (OR) adjusted for age= 21.80; 95% CI 16.49 to 28.81 and 4.77; 3.78 to 6.02, respectively). At A&E, 27,610 (71.5%) children had CRP <20 mg/L, of whom 42.5% were admitted, while 3,776 (9.8%) had CRP ≥ 80 mg/L with 57.9% admission rate. High and intermediate CRP values increased odds of admission versus low CRP (OR adjusted for age= 1.90; 95% CI 1.78 to 2.04 and 1.39; 1.32 to 1.46, respectively).</p>
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<p><strong>Conclusion:</strong> There are rising trends of CRP test requests at paediatric ambulatory care settings, with no evidence of increases in proportion of intermediate/high-test results in primary care. Low CRP values at primary care were linked to children managed at home, while almost half of children with low CRP values at A&E were admitted to hospital.</p> |
| first_indexed | 2024-09-25T04:10:32Z |
| format | Journal article |
| id | oxford-uuid:6d8aefeb-a386-4ec2-be20-cba319e3933a |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-09-25T04:10:32Z |
| publishDate | 2024 |
| publisher | BMJ Publishing Group |
| record_format | dspace |
| spelling | oxford-uuid:6d8aefeb-a386-4ec2-be20-cba319e3933a2024-06-18T15:51:33ZTrends in C-Reactive Protein testing: a retrospective cohort study in paediatric ambulatory care settingsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:6d8aefeb-a386-4ec2-be20-cba319e3933aEnglishSymplectic ElementsBMJ Publishing Group2024Alkhmees, MVan den Bruel, AHayward, GBlanker, MHWalker, ASHoltman, G<p><strong>Objectives</strong> This study aims to investigate CRP testing practices in paediatric ambulatory care across British primary care and accident and emergency (A&E) departments.</p> <br> <p><strong>Design, Setting, Participants:</strong> This retrospective cohort study included children <18 years old having ≥1 CRP test at primary care or A&E departments in Oxfordshire between 2007-2021.</p> <br> <p><Strong>Outcomes:</strong> We estimated the frequency and annual changes in CRP testing in both settings, and evaluated referral and admission patterns based on CRP levels: low (<20 mg/L), intermediate, or high (≥80 mg/L).</p> <br> <p><strong>Results</strong> Over 15 years, 91,540 CRP tests were requested in 63,226 children, with 33,882 (53.6%) in primary care and 29,344 (46.4%) in A&E. Both settings showed rising trends in test requests, with average annual percentage change of 3.0% (95% CI 1.2 to 4.7) in primary care and 11.5% (95% CI 8.6 to 14.6) in A&E. The proportion of intermediate/high-test results remained stable. In primary care, 50,709 (95.8%) of tests were <20 mg/L, with 99.0% of these children managed at home. High and intermediate CRP values increased odds of referral versus low CRP (Odds ratio (OR) adjusted for age= 21.80; 95% CI 16.49 to 28.81 and 4.77; 3.78 to 6.02, respectively). At A&E, 27,610 (71.5%) children had CRP <20 mg/L, of whom 42.5% were admitted, while 3,776 (9.8%) had CRP ≥ 80 mg/L with 57.9% admission rate. High and intermediate CRP values increased odds of admission versus low CRP (OR adjusted for age= 1.90; 95% CI 1.78 to 2.04 and 1.39; 1.32 to 1.46, respectively).</p> <br> <p><strong>Conclusion:</strong> There are rising trends of CRP test requests at paediatric ambulatory care settings, with no evidence of increases in proportion of intermediate/high-test results in primary care. Low CRP values at primary care were linked to children managed at home, while almost half of children with low CRP values at A&E were admitted to hospital.</p> |
| spellingShingle | Alkhmees, M Van den Bruel, A Hayward, G Blanker, MH Walker, AS Holtman, G Trends in C-Reactive Protein testing: a retrospective cohort study in paediatric ambulatory care settings |
| title | Trends in C-Reactive Protein testing: a retrospective cohort study in paediatric ambulatory care settings |
| title_full | Trends in C-Reactive Protein testing: a retrospective cohort study in paediatric ambulatory care settings |
| title_fullStr | Trends in C-Reactive Protein testing: a retrospective cohort study in paediatric ambulatory care settings |
| title_full_unstemmed | Trends in C-Reactive Protein testing: a retrospective cohort study in paediatric ambulatory care settings |
| title_short | Trends in C-Reactive Protein testing: a retrospective cohort study in paediatric ambulatory care settings |
| title_sort | trends in c reactive protein testing a retrospective cohort study in paediatric ambulatory care settings |
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