Please use this identifier to cite or link to this item:
10.1136/archdischild-2020-320992
Title: | Shock Index in the early assessment of febrile children at the emergency department : a prospective multicentre study |
Authors: | Hagedoorn, Nienke N. Zachariasse, Joany M. Borensztajn, Dorine Adriaansens, Elise Von Both, Ulrich Carrol, Enitan D. Eleftheriou, Irini Emonts, Marieke Van Der Flier, Michiel De Groot, Ronald Herberg, Jethro Adam Kohlmaier, Benno Lim, Emma Maconochie, Ian Martinón-Torres, Federico Nijman, Ruud Gerard Pokorn, Marko Rivero-Calle, Irene Tsolia, Maria Zavadska, Dace Zenz, Werner Levin, Michael Vermont, Clementien Moll, Henriette A. Department of Paediatrics |
Keywords: | epidemiology;physiology;3.2 Clinical medicine;1.1. Scientific article indexed in Web of Science and/or Scopus database;Pediatrics, Perinatology, and Child Health |
Issue Date: | Feb-2022 |
Citation: | Hagedoorn , N N , Zachariasse , J M , Borensztajn , D , Adriaansens , E , Von Both , U , Carrol , E D , Eleftheriou , I , Emonts , M , Van Der Flier , M , De Groot , R , Herberg , J A , Kohlmaier , B , Lim , E , Maconochie , I , Martinón-Torres , F , Nijman , R G , Pokorn , M , Rivero-Calle , I , Tsolia , M , Zavadska , D , Zenz , W , Levin , M , Vermont , C & Moll , H A 2022 , ' Shock Index in the early assessment of febrile children at the emergency department : a prospective multicentre study ' , Archives of Disease in Childhood , vol. 107 , no. 2 , pp. 116-122 . https://doi.org/10.1136/archdischild-2020-320992 |
Abstract: | Objective: (1) To derive reference values for the Shock Index (heart rate/systolic blood pressure) based on a large emergency department (ED) population of febrile children and (2) to determine the diagnostic value of the Shock Index for serious illness in febrile children. Design/setting: Observational study in 11 European EDs (2017-2018). Patients: Febrile children with measured blood pressure. Main outcome measures: Serious bacterial infection (SBI), invasive bacterial infection (IBI), immediate life-saving interventions (ILSIs) and intensive care unit (ICU) admission. The association between high Shock Index (>95th centile) and each outcome was determined by logistic regression adjusted for age, sex, referral, comorbidity and temperature. Additionally, we calculated sensitivity, specificity and negative/positive likelihood ratios (LRs). Results: Of 5622 children, 461 (8.2%) had SBI, 46 (0.8%) had IBI, 203 (3.6%) were treated with ILSI and 69 (1.2%) were ICU admitted. High Shock Index was associated with SBI (adjusted OR (aOR) 1.6 (95% CI 1.3 to 1.9)), ILSI (aOR 2.5 (95% CI 2.0 to 2.9)), ICU admission (aOR 2.2 (95% CI 1.4 to 2.9)) but not with IBI (aOR: 1.5 (95% CI 0.6 to 2.4)). For the different outcomes, sensitivity for high Shock Index ranged from 0.10 to 0.15, specificity ranged from 0.95 to 0.95, negative LRs ranged from 0.90 to 0.95 and positive LRs ranged from 1.8 to 2.8. Conclusions: High Shock Index is associated with serious illness in febrile children. However, its rule-out value is insufficient which suggests that the Shock Index is not valuable as a screening tool for all febrile children at the ED. |
Description: | Funding Information: Funding This work was supported by the European Union’s Horizon 2020 research and innovation programme (grant agreement no. 668303), by the National Institute for Health Research (NIHR) Biomedical Research Centres at Imperial College London, Newcastle Hospitals NHS Foundation Trust and Newcastle University, and by NIHR Academic Clinical Fellowship award (ACL-2018-21-00 to RN). Funding Information: This work was supported by the European Union's Horizon 2020 research and innovation programme (grant agreement no. 668303), by the National Institute for Health Research (NIHR) Biomedical Research Centres at Imperial College London, Newcastle Hospitals NHS Foundation Trust and Newcastle University, and by NIHR Academic Clinical Fellowship award (ACL-2018-21-00 to RN). Publisher Copyright: © |
DOI: | 10.1136/archdischild-2020-320992 |
ISSN: | 0003-9888 |
Appears in Collections: | Research outputs from Pure / Zinātniskās darbības rezultāti no ZDIS Pure |
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Shock_Index_in_the_early_assessment_of_febrile.pdf | 1.61 MB | Adobe PDF | View/Open |
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