对三个月龄以下发热婴儿进行危险分层标准管理的性能评估。

Performance of risk stratification criteria in the management of febrile young infants younger than three months of age.

机构信息

Pediatric Infectious Disease Unit, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Pediatric Division, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

出版信息

Acta Paediatr. 2018 Mar;107(3):496-503. doi: 10.1111/apa.14134. Epub 2017 Nov 15.

DOI:10.1111/apa.14134

PMID:29080319

Abstract

AIM

We evaluated the diagnosis, risk stratification and management of febrile infants under three months of age who presented to an Israeli paediatric emergency room (ER).

METHODS

This retrospective study enrolled all febrile infants examined in the paediatric ER of Soroka Medical Center during 2010-2013. The patients were classified into low-risk and high-risk subgroups and compared by age and ethnicity.

RESULTS

Overall, 2251 febrile infants (60.5% of Bedouin and 34.4% of Jewish ethnicity) were enrolled. Hospitalisation rates were higher among Bedouin vs. Jewish infants (55 vs. 39.8%, p < 0.001). Fever without localising signs was diagnosed in 1028 (45.6%) infants and 499 (48.5%) were hospitalised; 26% were stratified as high-risk and 74% as low-risk. Bedouin infants rates were more likely to be at high-risk (p = 0.001) and hospitalised (p < 0.001) than Jewish infants. With regard to low-risk infants, the incidence rates were higher before two months than two to three months of age (73.3 vs. 59%, p < 0.001), as were the hospitalisation rates (46.3 vs. 20.1%, p < 0.001). No differences were recorded for the hospitalisation rates of Bedouin and Jewish infants between the three daily shifts.

CONCLUSION

Major differences were recorded in hospitalisation rates, risk stratification and management of Bedouin and Jewish infants with fever without localising signs.

摘要

目的

我们评估了在以色列儿科急诊室就诊的三个月以下发热婴儿的诊断、风险分层和管理。

方法

这项回顾性研究纳入了 2010 年至 2013 年期间在索罗卡医疗中心儿科急诊室检查的所有发热婴儿。将患者分为低危和高危亚组，并按年龄和种族进行比较。

结果

共有 2251 例发热婴儿（56.5%为贝都因人，34.4%为犹太人）入组。与犹太婴儿相比，贝都因婴儿的住院率更高（55%比 39.8%，p<0.001）。1028 例（45.6%）婴儿无局部体征发热，499 例（48.5%）住院；26%为高危，74%为低危。与犹太婴儿相比，贝都因婴儿更有可能处于高危状态（p=0.001）并住院（p<0.001）。对于低危婴儿，两个月前的发病率高于两个月至三个月（73.3%比 59%，p<0.001），住院率也更高（46.3%比 20.1%，p<0.001）。三个不同班次的贝都因和犹太婴儿的住院率没有差异。