Trandai Brandon, Husainy Dalia, Rivera-Sepulveda Andrea
Department of Pediatrics, Nemours Children's Health, Orlando, FL, USA.
Department of Pediatrics, The University of Chicago, Chicago, IL, USA.
Clin Pediatr (Phila). 2025 May;64(4):583-593. doi: 10.1177/00099228241283280. Epub 2024 Sep 24.
The use of inflammatory markers (IMs) in the pediatric emergency department (PED) is broad and non-specific. This retrospective, cross-sectional study of children aged 3 months to 18 years evaluated the use of IMs in the PED. The reasons for IM use were provider practice (38%), ruling out a differential diagnosis (36%), and presence of comorbidities (18%). IMs are commonly used for gastroenterology, infectious diseases, and orthopedic diseases. A third had IMs without an indication. Forty-six percent of IM testing was indicated based on medical documentation, of which only 21% had abnormal IMs. Compared to the abnormal IM values by the on-site laboratory, the IM assessment using a receiver operating characteristic (ROC) curve threshold criterion had improved specificity and negative predictive value (NPV) based on the reason for IM use. This study suggests that the rate of abnormal IMs is low and does not affect patient outcomes in the PED.
炎症标志物(IMs)在儿科急诊科(PED)的使用广泛且不具有特异性。这项针对3个月至18岁儿童的回顾性横断面研究评估了IMs在PED中的使用情况。使用IMs的原因包括医生的习惯做法(38%)、排除鉴别诊断(36%)以及存在合并症(18%)。IMs常用于胃肠病学、传染病和骨科疾病。三分之一的IMs使用并无指征。基于医疗记录,46%的IM检测有指征,其中只有21%的IMs异常。与现场实验室检测的IM异常值相比,根据IM使用原因,采用受试者工作特征(ROC)曲线阈值标准进行的IM评估具有更高的特异性和阴性预测值(NPV)。这项研究表明,IMs异常率较低,且不影响PED患者的预后。