Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Martin, AJ; van, der, Velden, FJS; von, Both, U; Tsolia, MN; Zenz, W; Sagmeister, M; Vermont, C; de, Vries, G; Kolberg, L; Lim, E; Pokorn, M; Zavadska, D; Martinón-Torres, F; Rivero-Calle, I; Hagedoorn, NN; Usuf, E; Schlapbach, L; Kuijpers, TW; Pollard, AJ; Yeung, S; Fink, C; Voice, M; Carrol, E; Agyeman, PKA; Khanijau, A; Paulus, S; De, T; Herberg, JA; Levin, M; van, der, Flier, M; de, Groot, R; Nijman, R; Emonts, M, , PERFORM, consortium.
External validation of a multivariable prediction model for identification of pneumonia and other serious bacterial infections in febrile immunocompromised children.
Arch Dis Child. 2023; 109(1):58-66
Doi: 10.1136/archdischild-2023-325869
Web of Science
PubMed
FullText
FullText_MUG
- Co-authors Med Uni Graz
- Sagmeister Manfred Gerald
- Zenz Werner
- Study Group Members Med Uni Graz:
- Bauchinger Sebastian
- Baumgart Hinrich
- Benesch Martin
- Binder Alexander
- Eber Ernst
- Gallistl Siegfried
- Gores Gunther
- Haidl Harald
- Hauer Almuthe
- Keldorfer Markus
- Kohlfürst Daniela
- Kohlmaier Benno
- Krenn Larissa
- Leitner Manuel
- Löffler Sabine
- Niedrist Tobias Josef
- Nordberg Gudrun
- Pfleger Andreas
- Pfurtscheller Klaus
- Pilch Heidemarie
- Pölz Lena
- Rajic Glorija
- Roedl Siegfried
- Schweintzger Nina
- Skrabl-Baumgartner Andrea
- Sperl Matthias
- Stampfer Laura
- Strenger Volker
- Till Holger
- Trobisch Andreas
- Zurl Christoph Johann
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Scite (citation analytics):
- Abstract:
- OBJECTIVE: To externally validate and update the Feverkids tool clinical prediction model for differentiating bacterial pneumonia and other serious bacterial infections (SBIs) from non-SBI causes of fever in immunocompromised children. DESIGN: International, multicentre, prospective observational study embedded in PErsonalised Risk assessment in Febrile illness to Optimise Real-life Management across the European Union (PERFORM). SETTING: Fifteen teaching hospitals in nine European countries. PARTICIPANTS: Febrile immunocompromised children aged 0-18 years. METHODS: The Feverkids clinical prediction model predicted the probability of bacterial pneumonia, other SBI or no SBI. Model discrimination, calibration and diagnostic performance at different risk thresholds were assessed. The model was then re-fitted and updated. RESULTS: Of 558 episodes, 21 had bacterial pneumonia, 104 other SBI and 433 no SBI. Discrimination was 0.83 (95% CI 0.71 to 0.90) for bacterial pneumonia, with moderate calibration and 0.67 (0.61 to 0.72) for other SBIs, with poor calibration. After model re-fitting, discrimination improved to 0.88 (0.79 to 0.96) and 0.71 (0.65 to 0.76) and calibration improved. Predicted risk <1% ruled out bacterial pneumonia with sensitivity 0.95 (0.86 to 1.00) and negative likelihood ratio (LR) 0.09 (0.00 to 0.32). Predicted risk >10% ruled in bacterial pneumonia with specificity 0.91 (0.88 to 0.94) and positive LR 6.51 (3.71 to 10.3). Predicted risk <10% ruled out other SBIs with sensitivity 0.92 (0.87 to 0.97) and negative LR 0.32 (0.13 to 0.57). Predicted risk >30% ruled in other SBIs with specificity 0.89 (0.86 to 0.92) and positive LR 2.86 (1.91 to 4.25). CONCLUSION: Discrimination and calibration were good for bacterial pneumonia but poorer for other SBIs. The rule-out thresholds have the potential to reduce unnecessary investigations and antibiotics in this high-risk group.
- Find related publications in this database (using NLM MeSH Indexing)
- Child - administration & dosage
- Humans - administration & dosage
- Infant - administration & dosage
- Models, Statistical - administration & dosage
- Prognosis - administration & dosage
- Fever - etiology, microbiology
- Bacterial Infections - diagnosis
- Pneumonia, Bacterial - diagnosis, complications
- Communicable Diseases - administration & dosage
- Emergency Service, Hospital - administration & dosage
- Find related publications in this database (Keywords)
- Paediatrics
- Paediatric Emergency Medicine
- Infectious Disease Medicine
- Allergy and Immunology