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在苏丹的儿科急诊环境中,将生命体征用作急性发热性疾病儿童严重细菌感染的预测指标。

The use of vital signs as predictors for serious bacterial infections in children with acute febrile illness in a pediatric emergency setting in Sudan.

作者信息

Salah Elmuntasir Taha, Ahmed Emad, Elhussien Manal, Salah Tarig

机构信息

(1) Department of paediatrics, The National Ribat University, Khartoum, Sudan.

(2) Public health institute (PHI), Sudan.

出版信息

Sudan J Paediatr. 2014;14(2):35-40.

Abstract

Distinguishing children with serious infections from those with milder, self-limiting febrile illnesses remains a daily challenge in primary care and hospital emergency department. Measurement of vital signs is recommended as part of this assessment. To determine whether vital signs can predict children with serious bacterial infections, we studied the data of children aged 1 month to < 16 years presented who with acute febrile illness to a Pediatric emergency department in Sudan. Sample size was 150 patients. The severity of infection was classified as serious or not serious bacterial infection. Vital signs and oxygen saturation were recorded and compared to the final outcome of these children. Data analyzed bivariably and multivariably using regression analysis. Ten percent of patients were classified as having serious bacterial infection. Tachycardia and tachypnea were the most sensitive and specific in predicting serious bacterial infections with (80%, 86.6 % sensitivity) and (97.4%, 83.7% specificity), respectively. High temperature, severe hypoxemia and hypotension were the least sensitive but highly specific signs of serious bacterial infections. As a conclusion, vital signs can be used to differentiate children with serious bacterial infections from those with non-serious bacterial infections in pediatric emergency departments and has comparable sensitivity to more complicated triage systems.

摘要

在初级医疗保健和医院急诊科中,区分患有严重感染的儿童与患有较轻的、自限性发热疾病的儿童仍然是一项日常挑战。作为这项评估的一部分,建议测量生命体征。为了确定生命体征是否能够预测患有严重细菌感染的儿童,我们研究了苏丹一家儿科急诊科收治的1个月至未满16岁的急性发热疾病患儿的数据。样本量为150名患者。感染的严重程度分为严重或不严重的细菌感染。记录生命体征和血氧饱和度,并与这些儿童的最终诊断结果进行比较。使用回归分析对数据进行双变量和多变量分析。10%的患者被归类为患有严重细菌感染。心动过速和呼吸急促在预测严重细菌感染方面最敏感且具有特异性,敏感性分别为80%、86.6%,特异性分别为97.4%、83.7%。高热、严重低氧血症和低血压是严重细菌感染最不敏感但高度特异的体征。结论是,生命体征可用于在儿科急诊科区分患有严重细菌感染的儿童与非严重细菌感染的儿童,并且与更复杂的分诊系统具有相当的敏感性。

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