Predicting paediatric pneumonia severity in the emergency department: a multinational prospective cohort study of the Pediatric Emergency Research Network
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| Název: | Predicting paediatric pneumonia severity in the emergency department: a multinational prospective cohort study of the Pediatric Emergency Research Network |
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| Autoři: | Todd A Florin, Daniel J Tancredi, Lilliam Ambroggio, Franz E Babl, Stuart R Dalziel, Michelle Eckerle, Santiago Mintegi, Mark I Neuman, Amy C Plint, Norma-Jean Simon, Nathan Kuppermann, Fahd A Ahmad, Usha Avva, Luisa Barón González de Suso, Sarah Becker, Kelly R Bergmann, Stuart A Bradin, Kristen Breslin, Meredith L Borland, Rosa María Calderón Checa, Kerry Caperell, James Chamberlain, Pradip P Chaudhari, Jonathan Cherry, Shu-Ling Chong, Wee-Jhong Chua, Ida Concha, Simon Craig, Deepali Thosar, Andrew Dixon, Daniel M Fein, Antonella Frassanito, Stephen B Freedman, Karen Forward, Gafencu Mihai, Jara Gaitero Tristán, Annick Galetto-Lacour, Paula Forner García, Michael A Gardiner, Shane George, Valewska Gabriela Wallis Gómez, Virginia Gómez-Barrena, Raluca Isac, Adam Isacoff, Shefali Jani, April J Kam, Nirupama Kannikeswaran, Elizabeth M Keating, Amit Kochar, Maria Y Kwok, Anne M Lakes, Ben Lawton, Franziska Leeb, Susan C Lipsett, Matthew J Lipshaw, Maren M Lunoe, Ryan McKee, Son H McLaren, Lianne McLean, Garth D Meckler, Fabio Midulla, Erin Mills, Andrea Mora-Capín, Claudia R Morris, Nidhya Navanandan, Sharon L O'Brien, Ioannis Orfanos, Natalia Paniagua, Sonia Viviana Pavlicich, Naveen Poonai, Mercè Puigdomènech Fosch, Alexander Rogers, Carlos M Angelats, Vikram Sabhaney, Cyril Sahyoun, Frederic Samson, Laura Sartori, Usha Sethuraman, Nipam P Shah, Manuel E Soto-Martinez, Jorge Sotoca Fernandez, Pilar Storch-de-Gracia, Regina L Toto, Viet Tran, Muhammad Waseem, Leah Tzimenatos, Bruce Wright, Adriana Yock-Corrales, Joseph J Zorc |
| Přispěvatelé: | Galetto-Lacour, Annick, Sahyoun, Cyril |
| Zdroj: | The Lancet Child & Adolescent Health. 9:383-392 |
| Informace o vydavateli: | Elsevier BV, 2025. |
| Rok vydání: | 2025 |
| Témata: | Male, Community-Acquired Infections / epidemiology, Adolescent, Community-Acquired Infections / diagnosis, Infant, Pneumonia, Severity of Illness Index, Risk Assessment, Pneumonia / epidemiology, Community-Acquired Infections, Hospitalization, Hospitalization / statistics & numerical data, Risk Assessment / methods, Child, Preschool, Emergency Service, Hospital / statistics & numerical data, Humans, Female, Prospective Studies, Pneumonia / diagnosis, Child, Emergency Service, Hospital |
| Popis: | Risk stratification tools for paediatric community-acquired pneumonia (CAP) in well-resourced settings are scarce. We prospectively developed models to predict CAP severity within a multinational cohort of paediatric emergency departments (EDs). Our primary objective was to develop a risk prediction model to discriminate between mild CAP and moderate or severe CAP to assist clinicians in determining the need for hospitalisation.This prospective cohort study was conducted from Feb 6, 2019, to June 30, 2021, at 73 EDs in 14 countries. Children aged 3 months to 24 h, positive-pressure ventilation, septic shock, vasoactive infusions, extracorporeal membrane oxygenation, or death) occurring within 7 days of the ED visit. Models were developed using logistic regression with bootstrap validation.Of 2222 children in the overall study population (1103 [49·7%] female, 1119 [50·3%] male; median age 3 years [IQR 1-5]), 1290 (58·1%) had mild CAP, 812 (36·5%) moderate, and 120 (5·4%) severe. Primary analyses were performed in 1901 patients with complete data: 1011 (53·2%) mild, 772 (40·6%) moderate, and 118 (6·2%) severe CAP. Congestion or rhinorrhoea was negatively associated with moderate or severe CAP (adjusted odds ratio 0·59 [95% CI 0·46-0·76]), while abdominal pain (1·52 [1·17-1·97]), refusal to drink (1·57 [1·24-2·00]), antibiotics before ED visit (1·64 [1·29-2·10]), chest retractions (2·86 [2·24-3·65]), respiratory rate above the 95th percentile for age (1·63 [1·29-2·06]), heart rate above the 95th percentile for age (1·64 [1·27-2·12]), and hypoxaemia (oxygen saturation 90-92%, 3·24 [2·46-4·27] |
| Druh dokumentu: | Article |
| Popis souboru: | application/pdf |
| Jazyk: | English |
| ISSN: | 2352-4642 |
| DOI: | 10.1016/s2352-4642(25)00094-x |
| Přístupová URL adresa: | https://pubmed.ncbi.nlm.nih.gov/40379430 https://archive-ouverte.unige.ch/unige:187473 https://doi.org/10.1016/s2352-4642(25)00094-x |
| Rights: | Elsevier TDM |
| Přístupové číslo: | edsair.doi.dedup.....bb00fee1460c1ca069e24d84d01382f2 |
| Databáze: | OpenAIRE |
Nájsť tento článok vo Web of Science | Abstrakt: | Risk stratification tools for paediatric community-acquired pneumonia (CAP) in well-resourced settings are scarce. We prospectively developed models to predict CAP severity within a multinational cohort of paediatric emergency departments (EDs). Our primary objective was to develop a risk prediction model to discriminate between mild CAP and moderate or severe CAP to assist clinicians in determining the need for hospitalisation.This prospective cohort study was conducted from Feb 6, 2019, to June 30, 2021, at 73 EDs in 14 countries. Children aged 3 months to 24 h, positive-pressure ventilation, septic shock, vasoactive infusions, extracorporeal membrane oxygenation, or death) occurring within 7 days of the ED visit. Models were developed using logistic regression with bootstrap validation.Of 2222 children in the overall study population (1103 [49·7%] female, 1119 [50·3%] male; median age 3 years [IQR 1-5]), 1290 (58·1%) had mild CAP, 812 (36·5%) moderate, and 120 (5·4%) severe. Primary analyses were performed in 1901 patients with complete data: 1011 (53·2%) mild, 772 (40·6%) moderate, and 118 (6·2%) severe CAP. Congestion or rhinorrhoea was negatively associated with moderate or severe CAP (adjusted odds ratio 0·59 [95% CI 0·46-0·76]), while abdominal pain (1·52 [1·17-1·97]), refusal to drink (1·57 [1·24-2·00]), antibiotics before ED visit (1·64 [1·29-2·10]), chest retractions (2·86 [2·24-3·65]), respiratory rate above the 95th percentile for age (1·63 [1·29-2·06]), heart rate above the 95th percentile for age (1·64 [1·27-2·12]), and hypoxaemia (oxygen saturation 90-92%, 3·24 [2·46-4·27] |
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| ISSN: | 23524642 |
| DOI: | 10.1016/s2352-4642(25)00094-x |