Cozzi G, Tessitore A, Giangreco M, Cogo P, Valentini E, Salis S, Pascolo P, Barbi E. SBI is uncommon in the absence of paediatricians' gut feeling and abnormal respiratory pattern.
Acta Paediatr 2022;
111:2362-2368. [PMID:
36114734 PMCID:
PMC9826455 DOI:
10.1111/apa.16544]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/29/2022] [Accepted: 09/15/2022] [Indexed: 01/11/2023]
Abstract
AIM
According to the Italian national statistical institute, severe bacterial infections (SBI) in Italy are responsible for 1.7% of mortality under 5 years of age and their recognition is often challenging, especially in the first stages of the disease. We tried to estimate the prevalence of SBI in our target population and to identify signs and symptoms that could guide in the initial evaluation of a child with a possible SBI.
METHODS
We designed a prospective, multicentre study and enrolled patients aged 0-14 years at the first evaluation to the emergency department with an acute illness lasting a maximum of 5 days. The presence of variables suggestive of SBI was collected for every enrolled patient. One week after the enrolment, every patient was followed up by telephone.
RESULTS
SBI is more likely to be detected with the 'gut feeling' in both univariate and multivariate models (univariate OR: 7.16, 95% CI: 4.08-12.56; multivariate OR: 5.34, 95% CI: 2.78-10.25), while abnormal breathing pattern resulted significative only in univariate model (OR 3.83, 95% CI: 1.98-7.40). Nevertheless, their associated sensitivity is low.
CONCLUSION
SBI is uncommon in the absence of paediatricians' gut feeling and abnormal respiratory pattern.
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