Please use this identifier to cite or link to this item: https://doi.org/10.1186/s12887-019-1591-7
Title: Value of parental concern and clinician's gut feeling in recognition of serious bacterial infections : A prospective observational study
Authors: Urbane, Urzula Nora
Gaidule-Logina, Dita
Gardovska, Dace
Pavare, Jana
Department of Paediatrics
Keywords: Children;Fever;Paediatric emergency department;Serious bacterial infections;Pediatrics, Perinatology, and Child Health;3.2 Clinical medicine;1.1. Scientific article indexed in Web of Science and/or Scopus database
Issue Date: 3-Jul-2019
Citation: Urbane , U N , Gaidule-Logina , D , Gardovska , D & Pavare , J 2019 , ' Value of parental concern and clinician's gut feeling in recognition of serious bacterial infections : A prospective observational study ' , BMC Pediatrics , vol. 19 , no. 1 , 219 . https://doi.org/10.1186/s12887-019-1591-7
Abstract: Background: Serious bacterial infections (SBI) are a significant cause of mortality worldwide. Parental concern and clinician's gut feeling that there is something wrong has been associated with increased likelihood of developing SBI in primary care studies. The aim of this study is to assess the diagnostic value of parental concern and gut feeling at the emergency department of a tertiary hospital. Methods: This prospective observational study included children with fever attending the emergency department of Children's Clinical University hospital in Riga between October 2017 and July 2018. Data were collected via parental and clinician questionnaires. "Gut feeling" was defined as intuitive feeling that the child may have a serious illness, and "Sense of reassurance" as a feeling that the child has a self-limiting illness. "Parental concern" was defined as impression that this illness is different from previous illnesses. SBI included bacterial meningitis, sepsis, bacteraemia, pneumonia, urinary tract infection, appendicitis, bacterial gastroenteritis, and osteomyelitis. Pearson's Chi-Squared test or Fisher's exact test were used to compare the variables between children with and without SBI. Positive likelihood ratio was calculated for "gut feeling", "sense of reassurance", and parental concern. Results: The study included 162 patients aged 2 months to 17.8 years. Forty-six patients were diagnosed with SBI. "Sense of reassurance" expressed by all clinicians was associated with lower likelihood of SBI (positive likelihood ratio 8.8, 95% confidence interval 2.2-34.8). "Gut feeling" was not significantly predictive of the patient being diagnosed with SBI (positive likelihood ratio 3.1, 95% confidence interval 1.9-5.1), The prognostic rule-in value of parental concern was insignificant (positive likelihood ratio 1.4, 95% confidence interval 1.1-1.7). Conclusion: Sense of reassurance was useful in ruling out SBI. Parental concern was not significantly predictive of SBI.
Description: Funding Information: Authors are thankful to State Research programme “BIOMEDICINE”, Project No. 5.6.2. “Research on acute and chronic diseases in children of wide age range to develop diagnostic and therapeutic algorithms to reduce mortality, prolong survival and improve quality of life”. This manuscript was drafted as a part of the project. We thank all the participating clinicians and research team of data collectors. Funding Information: This research was funded by State Research programme “BIOMEDICINE”, Project No. 5.6.2. “Research on acute and chronic diseases in children of wide age range to develop diagnostic and therapeutic algorithms to reduce mortality, prolong survival and improve quality of life”. This manuscript was drafted as a part of the project. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. Publisher Copyright: © 2019 The Author(s).
DOI: https://doi.org/10.1186/s12887-019-1591-7
ISSN: 1471-2431
Appears in Collections:Research outputs from Pure / Zinātniskās darbības rezultāti no ZDIS Pure

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