응급실 방문한 소아 열 환자에서 Pediatric Risk of Admission 점수 I 및 II와 C-반응단백질 결합모형의 입원 예측성적
Performance of the combined models of Pediatric Risk of Admission scores I and II, and C-reactive protein for prediction of hospitalization in febrile children who visited the emergency department
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: To study the performance of the combined models of Pediatric Risk of Admission (PRISA) scores I and II and Creactive protein (CRP) for prediction of hospitalization in febrile children who visited the emergency department Methods: We reviewed febrile children aged 4 months-17 years who visited a tertiary hospital emergency department between January and December 2017. White blood cell count, CRP concentration, the PRISA scores, and systemic inflammatory response syndrome score were calculated. We compared areas under the curves (AUCs) of the admission decision support tools for hospitalization using receiver operating characteristic curve analysis. Results: Of 1,032 enrolled children, 423 (41.0%) were hospitalized. CRP and the PRISA scores were significantly higher in the hospitalization group than in the discharge group (all P < 0.001). Among the individual tools, CRP showed the highest AUC (0.69; 95% confidence interval [CI], 0.66-0.72). AUC was 0.71 (95% CI, 0.69-0.74) for the combined model of the PRISA I score and CRP, and 0.71 (95% CI, 0.68-0.74) for that of the PRISA II score and CRP. The AUC of PRISA score I and CRP combined was significantly higher than that of isolated CRP (P = 0.048). Conclusion: The combined model of the PRISA I score and CRP may be useful in predicting hospitalization of febrile children in emergency departments.
Abstract
Purpose: To study the performance of the combined models of Pediatric Risk of Admission (PRISA) scores I and II and Creactive protein (CRP) for prediction of hospitalization in febrile children who visited the emergency department Methods: We reviewed febrile children aged 4 months-17 years who visited a tertiary hospital emergency department between January and December 2017. White blood cell count, CRP concentration, the PRISA scores, and systemic inflammatory response syndrome score were calculated. We compared areas under the curves (AUCs) of the admission decision support tools for hospitalization using receiver operating characteristic curve analysis. Results: Of 1,032 enrolled children, 423 (41.0%) were hospitalized. CRP and the PRISA scores were significantly higher in the hospitalization group than in the discharge group (all P < 0.001). Among the individual tools, CRP showed the highest AUC (0.69; 95% confidence interval [CI], 0.66-0.72). AUC was 0.71 (95% CI, 0.69-0.74) for the combined model of the PRISA I score and CRP, and 0.71 (95% CI, 0.68-0.74) for that of the PRISA II score and CRP. The AUC of PRISA score I and CRP combined was significantly higher than that of isolated CRP (P = 0.048). Conclusion: The combined model of the PRISA I score and CRP may be useful in predicting hospitalization of febrile children in emergency departments.
참고문헌 (14)
- 김도균, "국내 응급실의 소아 진료 양상과 준비 수준; 전국 응급의료센터 설문 조사", 대한응급의학회지, 23(1), pp.126~131 (2012), 대한응급의학회
- Kwak YH., "Current status and future direction of pediatric emergency medicine in Korea", Pediatr Emerg Med J, 1, pp.1~10 (2014)
- 곽병곤, "소아응급실에 내원한 발열 환아에 대한 연구 분석", Clinical and Experimental Pediatrics, 49(8), pp.839~844 (2006), 대한소아청소년과학회
- Chamberlain JM, "Pediatric Risk of Admission (PRISA): a measure of severity of illness for assessing the risk of hospitalization from the emergency department", Ann Emerg Med, 32, pp.161~169 (1998)
- Chamberlain JM, "The Pediatric Risk of Hospital Admission Score: a second-generation severity-of-illness score for pediatric emergency patients", Pediatrics, 115, pp.388~395 (2005)
- Lacour AG, "Procalcitonin, IL-6, IL-8, IL-1 receptor antagonist and C-reactive protein as identificators of serious bacterial infections in children with fever without localising signs", Eur J Pediatr, 160, pp.95~100 (2001)
- Pulliam PN, "C-reactive protein in febrile children 1 to 36 months of age with clinically undetectable serious bacterial infection", Pediatrics, 108, pp.1275~1279 (2001)
- Isaacman DJ, "Utility of the serum C-reactive protein for detection of occult bacterial infection in children", Arch Pediatr Adolesc Med, 156, pp.905~909 (2002)
- Hu L, "Diagnostic value of PCT and CRP for detecting serious bacterial infections in patients with fever of unknown origin: a systematic review and meta-analysis", Appl Immunohistochem Mol Morphol, 25, pp.e61~e69 (2017)
- Honda T, "Neutrophil left shift and white blood cell count as markers of bacterial infection", Clin Chim Acta, 457, pp.46~53 (2016)
- El-Radhi AS, "An evaluation of tympanic thermometry in a paediatric emergency department", Emerg Med J, 23, pp.40~41 (2006)
- Chamberlain JM, "Determination of normal ear temperature with an infrared emission detection thermometer", Ann Emerg Med, 25, pp.15~20 (1995)
- Miles H, "The PATRIARCH Study. Using outcome measures for league tables: can a North American prediction of admission score be used in a United Kingdom children’s emergency department?", PRISA And Triage In A Regional Children’s Hospital. Emerg Med J, 19, pp.536~538 (2002)
- Gravel J, "Evaluation of the pediatric risk of admission score in a pediatric emergency department", Ann Emerg Med, 41, pp.630~638 (2003)