Hopman Anouk, Talsma Elise S, Mook-Kanamori Dennis O, Pas Arjan B Te, Narayen Ilona C
Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.
Department of Pediatrics, Radboud University Medical Center, Nijmegen, The Netherlands.
Eur J Pediatr. 2025 Apr 12;184(5):294. doi: 10.1007/s00431-025-06127-3.
Infants under 1 year old frequently visit the general practitioner with acute illnesses. Assessing the severity of illness in this group can be challenging as signs and symptoms may be observed in both sick and healthy infants. Current triage systems are primarily designed for older children and adults and have been validated mainly in high-prevalence settings, such as emergency departments. As a result, these systems often result in undertriage, which can lead to delayed treatment and adverse outcomes.
This review reports the existing triage and scoring systems, currently used in infants. We discuss the strengths and limitations of this systems. Furthermore, we explore how the integration of clinical features with vital signs, such as heart rate and oxygen saturation, can improve the accuracy of triage for infants. The BabyCheck, validated for use in primary care for infants under 6 months of age, and the use of pulse oximetry offer promising improvements. Further research is essential to develop and validate an optimal triage system for infants under one year of age in the general practitioner setting.
• Current triage systems are widely used in emergency departments but show limitations, especially when applied to infants. • These existing triage systems often result in undertriage or overtriage, which can lead to either unnecessary healthcare utilization or delayed treatment for serious conditions.
• Combining vital signs such as heart rate and oxygen saturation with clinical features, may improve the accuracy of triage systems for infants.
1岁以下婴儿经常因急性疾病就诊于全科医生处。评估该群体疾病的严重程度具有挑战性，因为患病和健康的婴儿都可能出现体征和症状。当前的分诊系统主要是为年龄较大的儿童和成人设计的，并且主要在急诊等高发病率环境中得到验证。因此，这些系统常常导致分诊不足，进而可能导致治疗延迟和不良后果。
本综述报告了目前在婴儿中使用的现有分诊和评分系统。我们讨论了这些系统的优缺点。此外，我们探讨了如何将临床特征与心率和血氧饱和度等生命体征相结合，以提高婴儿分诊的准确性。已验证可用于6个月以下婴儿初级护理的BabyCheck以及脉搏血氧饱和度测定的应用提供了有前景的改进方法。进一步的研究对于在全科医生环境中开发和验证针对1岁以下婴儿的最佳分诊系统至关重要。
• 当前的分诊系统在急诊科广泛使用，但存在局限性，尤其是应用于婴儿时。• 这些现有的分诊系统常常导致分诊不足或过度分诊，这可能导致不必要的医疗资源利用或严重疾病的治疗延迟。
• 将心率和血氧饱和度等生命体征与临床特征相结合，可能提高婴儿分诊系统的准确性。
