Systematic review and validation of prediction rules for identifying children with serious infections in emergency departments and urgent-access primary care.

作者：Matthew Thompson, A Van den Bruel, Jan Y. Verbakel, Monica Lakhanpaul, T Haj-Hassan, Richard Stevens, Henriëtte A. Moll, Frank Buntinx, Marjolein Y. Berger, Bert Aertgeerts, Rianne Oostenbrink, David Mant · 发表于：Health Technology Assessment · 年份：2012 · DOI：10.3310/hta16150 · 被引用次数：326 · 研究领域：Sepsis Diagnosis and Treatment、Clinical Reasoning and Diagnostic Skills、Respiratory viral infections research

BACKGROUND: Although the vast majority of children with acute infections are managed at home, this is one of the most common problems encountered in children attending emergency departments (EDs) and primary care. Distinguishing children with serious infection from those with minor or self-limiting infection is difficult. This can result in misdiagnosis of children with serious infections, which results in a poorer health outcome, or a tendency to refer or admit children as a precaution; thus, inappropriately utilising secondary-care resources. OBJECTIVES: We systematically identified clinical features and laboratory tests which identify serious infection in children attending the ED and primary care. We also identified clinical prediction rules and validated those using existing data sets. DATA SOURCES: We searched MEDLINE, Medion, EMBASE, Cumulative Index to Nursing and Allied Health Literature and Database of Abstracts of Reviews of Effects in October 2008, with an update in June 2009, using search terms that included terms related to five components: serious infections, children, clinical history and examination, laboratory tests and ambulatory care settings. We also searched references of included studies, clinical content experts, and relevant National Institute for Health and Clinical Excellence guidelines to identify relevant studies. There were no language restrictions. Studies were eligible for inclusion if they were based in ambulatory settings in economically deve...