发烧婴儿算法的表现根据发烧持续时间
Roberto Velasco1,2, Borja Gomez3, Ismael Labiano3
1Pediatric Emergency Unit, Hospital Universitari Parc Tauli, Institut d'Investigació i Innovació I3PT, Sabadell, Spain.
Pediatrics
|April 2, 2024
概括
婴儿的短时间发烧显著降低了常见的血液检测对侵入性细菌感染的准确性. 在这些情况下,甲素表现比其他生物标志物和临床规则更好.
科学领域:
- 儿科急救医学 儿科急救医学
- 传染性疾病 传染性疾病
- 临床诊断 临床诊断 临床诊断
背景情况:
- 90天以下发烧的婴儿需要对侵入性细菌感染 (IBI) 进行仔细评估.
- 临床决策规则和血液生物标志物用于识别低风险婴儿.
- 发烧持续时间对这些诊断工具的性能的影响尚未完全理解.
研究的目的:
- 为了分析发烧的婴儿90天以下的血液测试的诊断性能.
- 评估发烧持续时间如何影响识别IBI低风险婴儿的准确性.
- 为了比较生物标志物的有效性和基于发烧持续时间的确定的临床决策规则.
主要方法:
- 未来注册婴儿 ≤90天发烧没有源头的二次分析.
- 婴儿根据发烧持续时间分为几组:<2小时,2-12小时,≥12小时.
- 评估生物标志物 (绝对中性粒细胞计数,C反应蛋白,甲) 和临床规则 (PECARN,AAP,一步一步).
主要成果:
- 在2411名婴儿中,侵袭性细菌感染被诊断为3.0%的婴儿.
- 生物标志物的表现,除了前素,在发烧小于2小时的婴儿中显著下降.
- 与临床规则相比,甲尼在体型良好,发烧小于2小时的婴儿中表现出更高的敏感性 (100%).
结论:
- 大多数血液生物标志物在发烧的婴儿中检测IBI的准确性会随着发烧持续时间非常短而下降.
- 当发烧持续时间小于2小时时,前素似乎比其他生物标志物和临床决策规则更可靠.
- 发烧持续时间是影响发烧婴儿诊断工具可靠性的关键因素.
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