Τίτλος:
Characteristics and management of adolescents attending the ED with fever: A prospective multicentre study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objective Most studies on febrile children have focused on infants and young children with serious bacterial infection (SBI). Although population studies have described an increased risk of sepsis in adolescents, little is known about febrile adolescents attending the emergency department (ED). We aimed to describe patient characteristics and management of febrile adolescents attending the ED. Design and setting The MOFICHE/PERFORM study (Management and Outcome of Febrile Children in Europe/Personalised Risk assessment in Febrile illness to Optimise Real-life Management across the European Union), a prospective multicentre study, took place at 12 European EDs. Descriptive and multivariable regression analyses were performed, comparing febrile adolescents (12-18 years) with younger children in terms of patient characteristics, markers of disease severity (vital signs, clinical alarming signs), management (diagnostic tests, therapy, admission) and diagnosis (focus, viral/bacterial infection). Results 37 420 encounters were included, of which 2577 (6.9%) were adolescents. Adolescents were more often triaged as highly urgent (38.9% vs 34.5%) and described as ill appearing (23.1% vs 15.6%) than younger children. Increased work of breathing and a non-blanching rash were present less often in adolescents, while neurological signs were present more often (1% vs 0%). C reactive protein tests were performed more frequently in adolescents and were more often abnormal (adjusted OR (aOR) 1.7, 95% CI 1.5 to 1.9). Adolescents were more often diagnosed with SBI (OR 1.8, 95% CI 1.6 to 2.0) and sepsis/meningitis (OR 2.3, 95% CI 1.1 to 5.0) and were more frequently admitted (aOR 1.3, 95% CI 1.2 to 1.4) and treated with intravenous antibiotics (aOR 1.7, 95% CI 1.5 to 2.0). Conclusions Although younger children presented to the ED more frequently, adolescents were more often diagnosed with SBI and sepsis/meningitis. Our data emphasise the importance of awareness of severe infections in adolescents. © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.
Συγγραφείς:
Borensztajn, D.
Hagedoorn, N.N.
Carrol, E.
Von Both, U.
Dewez, J.E.
Emonts, M.
Van Der Flier, M.
De Groot, R.
Herberg, J.
Kohlmaier, B.
Levin, M.
Lim, E.
Maconochie, I.
Martinon Torres, F.
Nijman, R.
Pokorn, M.
Rivero-Calle, I.
Tsolia, M.
Vermont, C.
Zavadska, D.
Zenz, W.
Zachariasse, J.
Moll, H.A.
Περιοδικό:
BMJ Open Ophthalmology
Εκδότης:
BMJ Publishing Group
Λέξεις-κλειδιά:
antibiotic agent; C reactive protein, adolescent; adult; Article; bacterial infection; child; diagnostic test; disease severity; emergency ward; European; female; fever; hospital admission; human; major clinical study; male; meningitis; multicenter study; neurologic disease; oxygen saturation; prospective study; rash; risk assessment; sepsis; tachycardia; tachypnea; virus infection; vital sign; work of breathing
DOI:
10.1136/bmjopen-2021-053451
