Performance of risk stratification criteria in the management of febrile young infants younger than three months of age. (15th November 2017)

• Record Type: Journal Article
• Authors: Belov, Yekaterina; Leibovitz, Eugene; Vodonos, Alina; Hazan, Guy; Ling, Eduard; Melamed, Rimma
• Is Part Of: Acta pædiatrica. Volume 107:Number 3(2018)
• Page Start: 496
• Page End: 503
• Publication Date: 2017-11-15
• Subjects: Fever without source -- Hospitalisation -- Infants -- Risk stratification -- Rochester criteria; Pediatrics -- Periodicals; Pediatrics; 618.92
• DOI: 10.1111/apa.14134
• Languages: English
• ISSNs: 0803-5253

Abstract

Abstract: Aim: We evaluated the diagnosis, risk stratification and management of febrile infants under three months of age who presented to an Israeli paediatric emergency room (ER). Methods: This retrospective study enrolled all febrile infants examined in the paediatric ER of Soroka Medical Center during 2010–2013. The patients were classified into low‐risk and high‐risk subgroups and compared by age and ethnicity. Results: Overall, 2251 febrile infants (60.5% of Bedouin and 34.4% of Jewish ethnicity) were enrolled. Hospitalisation rates were higher among Bedouin vs. Jewish infants (55 vs. 39.8%, p < 0.001). Fever without localising signs was diagnosed in 1028 (45.6%) infants and 499 (48.5%) were hospitalised; 26% were stratified as high‐risk and 74% as low‐risk. Bedouin infants rates were more likely to be at high‐risk (p = 0.001) and hospitalised (p < 0.001) than Jewish infants. With regard to low‐risk infants, the incidence rates were higher before two months than two to three months of age (73.3 vs. 59%, p < 0.001), as were the hospitalisation rates (46.3 vs. 20.1%, p < 0.001). No differences were recorded for the hospitalisation rates of Bedouin and Jewish infants between the three daily shifts. Conclusion: Major differences were recorded in hospitalisation rates, risk stratification and management of Bedouin and Jewish infants with fever without localising signs.