New multivariable prediction model PEdiatric SEpsis recognition and stratification (PESERS score) shows excellent discriminatory capacity.


Journal

Acta paediatrica (Oslo, Norway : 1992)
ISSN: 1651-2227
Titre abrégé: Acta Paediatr
Pays: Norway
ID NLM: 9205968

Informations de publication

Date de publication:
06 2022
Historique:
revised: 16 02 2022
received: 27 10 2021
accepted: 07 03 2022
pubmed: 10 3 2022
medline: 14 5 2022
entrez: 9 3 2022
Statut: ppublish

Résumé

To develop a quantitative predictive scoring model for the early recognition and assessment of paediatric sepsis. Prospective observational study including emergency department and in-hospital febrile patients under 18 years. Sepsis diagnose (Goldstein 2005 definitions) was the main outcome. Variables associated with the outcome were included in a multivariable analysis. Cut-off points, odds ratio and coefficients for the variables kept after the multivariable analysis were identified. The score was obtained from the coefficients, The AUC was obtained from ROC-analysis, and internal validation was performed using k-fold cross-validation. The analysis included 210 patients. 45 variables were evaluated and the bivariate analysis identified 24 variables associated with the outcome. After the multivariable regression, 11 variables were kept and the score was obtained. The model yielded an excellent AUC of 0.886 (95% CI 0.845-0.927), p < 0.001 for sepsis recognition. With a cut-off value of 5 for the score, we obtained a sensitivity of 98%, specificity of 76.7%, positive predictive value of 87.9% and negative predictive value of 93.3%. The proposed scoring model for paediatric sepsis showed adequate discriminatory capacity and sufficient accuracy, which is of great clinical significance in detecting sepsis early and predicting its severity. Nevertheless external validation is needed before clinical use.

Identifiants

pubmed: 35263468
doi: 10.1111/apa.16321
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

1209-1219

Informations de copyright

© 2022 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

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Auteurs

Anna Solé-Ribalta (A)

Paediatric Intensive Care Unit Service, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
Immunological and Respiratory Disorders in the Paediatric Critical Patient Research Group, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain.
Paediatric Emergency Transport Team, Hospital Sant Joan de Déu, Barcelona, Spain.

Cristian Launes (C)

Paediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, CIBERESP, Barcelona, Spain.
Department of Paediatrics, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.

Aida Felipe-Villalobos (A)

Paediatric Intensive Care Unit Service, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
Immunological and Respiratory Disorders in the Paediatric Critical Patient Research Group, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain.

Mònica Balaguer (M)

Paediatric Intensive Care Unit Service, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
Immunological and Respiratory Disorders in the Paediatric Critical Patient Research Group, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain.

Carles Luaces (C)

Emergency Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.

Roser Garrido (R)

Emergency Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.

Sara Bobillo-Pérez (S)

Paediatric Intensive Care Unit Service, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
Immunological and Respiratory Disorders in the Paediatric Critical Patient Research Group, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain.

Mònica Girona-Alarcón (M)

Paediatric Intensive Care Unit Service, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
Immunological and Respiratory Disorders in the Paediatric Critical Patient Research Group, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain.
Paediatric Emergency Transport Team, Hospital Sant Joan de Déu, Barcelona, Spain.

Ana Valls (A)

Biochemistry Laboratory at the Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.

Francisco José Cambra (FJ)

Paediatric Intensive Care Unit Service, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
Immunological and Respiratory Disorders in the Paediatric Critical Patient Research Group, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain.

Elisabeth Esteban (E)

Paediatric Intensive Care Unit Service, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
Immunological and Respiratory Disorders in the Paediatric Critical Patient Research Group, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain.
Paediatric Emergency Transport Team, Hospital Sant Joan de Déu, Barcelona, Spain.

Iolanda Jordan (I)

Paediatric Intensive Care Unit Service, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
Immunological and Respiratory Disorders in the Paediatric Critical Patient Research Group, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain.
Paediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, CIBERESP, Barcelona, Spain.

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