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- Title
Clinical predictors of hospital admission in acute lower respiratory tract infection in 2 months to 2-year-old children.
- Authors
Mahajan, Vidushi; Tiwari, Mudita; Arya, Adhi; Tiwari, Abhimanyu; Chawla, Deepak; Saini, Shiv Sajan
- Abstract
Background and objective Acute lower respiratory tract infections ( ALRI) are a common cause of paediatric emergency visits in young children. We studied risk factors for hospitalization and developed a clinical score for predicting hospitalization among 2 months to 2-year-old children with ALRI. Methods We conducted this prospective cohort study in the paediatric emergency department of a tertiary-care teaching hospital in India. Consecutive children, aged 2 months to 2 years with ALRI were enrolled from 15 December 2011 to 14 December 2012. A total of 26 a priori identified, putative risk factors were studied among enrolled children. We determined independent predictors of hospital admission (primary outcome) through multi-variable logistic regression analysis and assimilated them into a clinical risk score using regression coefficients. Results A total of 240 children (130 admissions) with ALRI were enrolled. Eleven clinical risk factors, which displayed association with hospital admission on univariate analysis ( P < 0.1), were entered into multi-variable logistic regression analysis. Five factors retained independent association and were incorporated in a predictive score for hospitalization: tachypnoea (score of 5), chest retractions (score of 3), temperature > 37.8°C (score of 3), Sp O2 < 92% at room air (score of 4), GCS < 15 (score of 6). Area under the receiver operator characteristic curve was 0.80 (95% CI: 0.75-0.85, P < 0.001). Conclusion Five clinical risk factors-tachypnoea, chest retractions, fever > 37.8°C, Sp O2 < 92% and GCS < 15-independently predicted hospital admission in infants with ALRI. A novel clinical score predicting hospital admission is presented.
- Subjects
HOSPITAL utilization; RESPIRATORY infections in children; PNEUMONIA in children; EMERGENCY medical services; EMERGENCY medicine; FORECASTING
- Publication
Respirology, 2016, Vol 21, Issue 2, p350
- ISSN
1323-7799
- Publication type
Article
- DOI
10.1111/resp.12684