Guideline adherence in febrile children below 3 months visiting European Emergency Departments : an observational multicenter study

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dc.contributor.authorTan, Chantal D.
dc.contributor.authorvan der Walle, Eline E.P.L.
dc.contributor.authorVermont, Clementien L.
dc.contributor.authorZavadska, Dace
dc.contributor.authorPERFORM consortium (Personalised Risk assessment in febrile children to optimize Real-life Management across the European Union)
dc.contributor.authorBalode, Anda
dc.contributor.authorBārzdiņa, Arta
dc.contributor.authorGardovska, Dace
dc.contributor.authorGrāvele, Dagne
dc.contributor.authorGrope, Ilze
dc.contributor.authorMeiere, Anija
dc.contributor.authorNokalna, Ieva
dc.contributor.authorPavāre, Jana
dc.contributor.authorPučuka, Zanda
dc.contributor.authorUrbāne, Urzula Nora
dc.contributor.authorDeksne, Dārta
dc.contributor.authorSelecka, Katrina
dc.contributor.authorSidorova, Aleksandra
dc.contributor.institutionDepartment of Paediatrics
dc.contributor.institutionRīga Stradiņš University
dc.date.accessioned2022-11-21T14:25:01Z
dc.date.available2022-11-21T14:25:01Z
dc.date.issued2022-12
dc.descriptionFunding Information: This project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No. 848196. The Research was supported by the National Institute for Health Research Biomedical Research Centres at Imperial College London, Newcastle Hospitals NHS Foundation Trust and Newcastle University. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. For the remaining authors, no sources of funding were declared. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Publisher Copyright: © 2022, The Author(s).
dc.description.abstractFebrile children below 3 months have a higher risk of serious bacterial infections, which often leads to extensive diagnostics and treatment. There is practice variation in management due to differences in guidelines and their usage and adherence. We aimed to assess whether management in febrile children below 3 months attending European Emergency Departments (EDs) was according to the guidelines for fever. This study is part of the MOFICHE study, which is an observational multicenter study including routine data of febrile children (0–18 years) attending twelve EDs in eight European countries. In febrile children below 3 months (excluding bronchiolitis), we analyzed actual management compared to the guidelines for fever. Ten EDs applied the (adapted) NICE guideline, and two EDs applied local guidelines. Management included diagnostic tests, antibiotic treatment, and admission. We included 913 children with a median age of 1.7 months (IQR 1.0–2.3). Management per ED varied as follows: use of diagnostic tests 14–83%, antibiotic treatment 23–54%, admission 34–86%. Adherence to the guideline was 43% (374/868) for blood cultures, 29% (144/491) for lumbar punctures, 55% (270/492) for antibiotic prescriptions, and 67% (573/859) for admission. Full adherence to these four management components occurred in 15% (132/868, range 0–38%), partial adherence occurred in 56% (484/868, range 35–77%). Conclusion: There is large practice variation in management. The guideline adherence was limited, but highest for admission which implies a cautious approach. Future studies should focus on guideline revision including new biomarkers in order to optimize management in young febrile children.What is Known:• Febrile children below 3 months have a higher risk of serious bacterial infections, which often leads to extensive diagnostics and treatment.• There is practice variation in management of young febrile children due to differences in guidelines and their usage and adherence.What is New:• Full guideline adherence is limited, whereas partial guideline adherence is moderate in febrile children below 3 months across Europe.• Guideline revision including new biomarkers is needed to improve management in young febrile children.en
dc.description.statusPeer reviewed
dc.format.extent11
dc.format.extent929890
dc.identifier.citationTan, C D, van der Walle, E E P L, Vermont, C L, Zavadska, D, PERFORM consortium (Personalised Risk assessment in febrile children to optimize Real-life Management across the European Union), Balode, A, Bārzdiņa, A, Gardovska, D, Grāvele, D, Grope, I, Meiere, A, Nokalna, I, Pavāre, J, Pučuka, Z, Urbāne, U N, Deksne, D, Selecka, K & Sidorova, A 2022, 'Guideline adherence in febrile children below 3 months visiting European Emergency Departments : an observational multicenter study', European Journal of Pediatrics, vol. 181, no. 12, pp. 4199-4209. https://doi.org/10.1007/s00431-022-04606-5
dc.identifier.doi10.1007/s00431-022-04606-5
dc.identifier.issn0340-6199
dc.identifier.urihttps://dspace.rsu.lv/jspui/handle/123456789/9795
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85139213681&partnerID=8YFLogxK
dc.identifier.urlhttps://static-content.springer.com/esm/art%3A10.1007%2Fs00431-022-04606-5/MediaObjects/431_2022_4606_MOESM1_ESM.pdf
dc.language.isoeng
dc.relation.ispartofEuropean Journal of Pediatrics
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectChildren
dc.subjectEmergency care
dc.subjectFever
dc.subjectGuideline
dc.subjectPediatrics
dc.subject3.2 Clinical medicine
dc.subject1.1. Scientific article indexed in Web of Science and/or Scopus database
dc.subjectPediatrics, Perinatology, and Child Health
dc.titleGuideline adherence in febrile children below 3 months visiting European Emergency Departments : an observational multicenter studyen
dc.type/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article

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