Characteristics and management of adolescents attending the ED with fever : A prospective multicentre study

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dc.contributor.authorBorensztajn, Dorine
dc.contributor.authorHagedoorn, Nienke N.
dc.contributor.authorCarrol, Enitan
dc.contributor.authorVon Both, Ulrich
dc.contributor.authorDewez, Juan Emmanuel
dc.contributor.authorEmonts, Marieke
dc.contributor.authorVan Der Flier, Michiel
dc.contributor.authorDe Groot, Ronald
dc.contributor.authorHerberg, Jethro
dc.contributor.authorKohlmaier, Benno
dc.contributor.authorLevin, Michael
dc.contributor.authorLim, Emma
dc.contributor.authorMaconochie, Ian
dc.contributor.authorMartinon Torres, Federico
dc.contributor.authorNijman, Ruud
dc.contributor.authorPokorn, Marko
dc.contributor.authorRivero-Calle, Irene
dc.contributor.authorTsolia, Maria
dc.contributor.authorVermont, Clementien
dc.contributor.authorZavadska, Dace
dc.contributor.authorZenz, Werner
dc.contributor.authorZachariasse, Joany
dc.contributor.authorMoll, Henriette A.
dc.contributor.institutionDepartment of Paediatrics
dc.date.accessioned2022-02-28T09:10:02Z
dc.date.available2022-02-28T09:10:02Z
dc.date.issued2022-01-19
dc.descriptionFunding Information: Funding This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement number 668303. The research was supported by the National Institute for Health Research Biomedical Research Centre based at Imperial College (JH, ML) and at Newcastle Hospitals NHS Foundation Trust and Newcastle University (EL, ME). Publisher Copyright: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.
dc.description.abstractObjective Most studies on febrile children have focused on infants and young children with serious bacterial infection (SBI). Although population studies have described an increased risk of sepsis in adolescents, little is known about febrile adolescents attending the emergency department (ED). We aimed to describe patient characteristics and management of febrile adolescents attending the ED. Design and setting The MOFICHE/PERFORM study (Management and Outcome of Febrile Children in Europe/Personalised Risk assessment in Febrile illness to Optimise Real-life Management across the European Union), a prospective multicentre study, took place at 12 European EDs. Descriptive and multivariable regression analyses were performed, comparing febrile adolescents (12-18 years) with younger children in terms of patient characteristics, markers of disease severity (vital signs, clinical alarming signs), management (diagnostic tests, therapy, admission) and diagnosis (focus, viral/bacterial infection). Results 37 420 encounters were included, of which 2577 (6.9%) were adolescents. Adolescents were more often triaged as highly urgent (38.9% vs 34.5%) and described as ill appearing (23.1% vs 15.6%) than younger children. Increased work of breathing and a non-blanching rash were present less often in adolescents, while neurological signs were present more often (1% vs 0%). C reactive protein tests were performed more frequently in adolescents and were more often abnormal (adjusted OR (aOR) 1.7, 95% CI 1.5 to 1.9). Adolescents were more often diagnosed with SBI (OR 1.8, 95% CI 1.6 to 2.0) and sepsis/meningitis (OR 2.3, 95% CI 1.1 to 5.0) and were more frequently admitted (aOR 1.3, 95% CI 1.2 to 1.4) and treated with intravenous antibiotics (aOR 1.7, 95% CI 1.5 to 2.0). Conclusions Although younger children presented to the ED more frequently, adolescents were more often diagnosed with SBI and sepsis/meningitis. Our data emphasise the importance of awareness of severe infections in adolescents.en
dc.description.statusPeer reviewed
dc.format.extent2866037
dc.identifier.citationBorensztajn, D, Hagedoorn, N N, Carrol, E, Von Both, U, Dewez, J E, Emonts, M, Van Der Flier, M, De Groot, R, Herberg, J, Kohlmaier, B, Levin, M, Lim, E, Maconochie, I, Martinon Torres, F, Nijman, R, Pokorn, M, Rivero-Calle, I, Tsolia, M, Vermont, C, Zavadska, D, Zenz, W, Zachariasse, J & Moll, H A 2022, 'Characteristics and management of adolescents attending the ED with fever : A prospective multicentre study', BMJ Open, vol. 12, no. 1, e053451. https://doi.org/10.1136/bmjopen-2021-053451
dc.identifier.doi10.1136/bmjopen-2021-053451
dc.identifier.issn2044-6055
dc.identifier.urihttps://dspace.rsu.lv/jspui/handle/123456789/7646
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85123661016&partnerID=8YFLogxK
dc.language.isoeng
dc.relation.ispartofBMJ Open
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectpaediatric A&E and ambulatory care
dc.subjectpaediatric infectious disease & immunisation
dc.subjectpaediatrics
dc.subject3.2 Clinical medicine
dc.subject3.3 Health sciences
dc.subject1.1. Scientific article indexed in Web of Science and/or Scopus database
dc.subjectGeneral Medicine
dc.subjectSDG 3 - Good Health and Well-being
dc.titleCharacteristics and management of adolescents attending the ED with fever : A prospective multicentre studyen
dc.type/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article

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