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The clinical respiratory score predicts paediatric critical care disposition in children with respiratory distress presenting to the emergency department
BACKGROUND: Respiratory distress is a common presenting complaint in children brought to the Emergency Department (ED). The Clinical Respiratory Score (CRS) has shown promise as a screen for severe illness in High Income Countries. We aimed to validate the admission CRS in children presenting to the...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6208017/ https://www.ncbi.nlm.nih.gov/pubmed/30376827 http://dx.doi.org/10.1186/s12887-018-1317-2 |
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author | Nayani, Kanwal Naeem, Rubaba Munir, Owais Naseer, Naureen Feroze, Asher Brown, Nick Mian, Asad I. |
author_facet | Nayani, Kanwal Naeem, Rubaba Munir, Owais Naseer, Naureen Feroze, Asher Brown, Nick Mian, Asad I. |
author_sort | Nayani, Kanwal |
collection | PubMed |
description | BACKGROUND: Respiratory distress is a common presenting complaint in children brought to the Emergency Department (ED). The Clinical Respiratory Score (CRS) has shown promise as a screen for severe illness in High Income Countries. We aimed to validate the admission CRS in children presenting to the ED of a Low-to Middle Income Country. METHODS: Children (1 month to 16 years) presenting with respiratory distress to the ED of the Aga Khan University Hospital, Karachi, Pakistan, between November 2015 to March 2016, were enrolled. The CRS was measured at initial presentation, prior to any management and 2 h after treatment was started. The predictive value for admission to the paediatric critical care units for a variety of cut offs for CRS at presentation were derived. RESULTS: A total of 112 children (70% male) of median age 12 months (IQR 2, 34.5 months) were enrolled. Patients with severe CRS (score 8–12) at presentation were more likely to be admitted to paediatric critical care (90% vs. 23% with mild-moderate CRS; OR: 5.7; 95% CI: 2.2–15.3, p < 0.001). The sensitivity and specificity of CRS > 3 in predicting outcome were 94% (95% CI 79.8–99.3) and 40% (95% CI 35–45), respectively, with a positive likelihood ratio of 1.6 (95% CI 1.31–1.98) and negative predictive value of 94% (95% CI 81–98). CONCLUSION: An admission CRS of > 3 in the ED of a Low-to Middle Income Country had excellent predictive value for disease severity, and it should be considered for incorporation into ED triage protocols. |
format | Online Article Text |
id | pubmed-6208017 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-62080172018-11-16 The clinical respiratory score predicts paediatric critical care disposition in children with respiratory distress presenting to the emergency department Nayani, Kanwal Naeem, Rubaba Munir, Owais Naseer, Naureen Feroze, Asher Brown, Nick Mian, Asad I. BMC Pediatr Research Article BACKGROUND: Respiratory distress is a common presenting complaint in children brought to the Emergency Department (ED). The Clinical Respiratory Score (CRS) has shown promise as a screen for severe illness in High Income Countries. We aimed to validate the admission CRS in children presenting to the ED of a Low-to Middle Income Country. METHODS: Children (1 month to 16 years) presenting with respiratory distress to the ED of the Aga Khan University Hospital, Karachi, Pakistan, between November 2015 to March 2016, were enrolled. The CRS was measured at initial presentation, prior to any management and 2 h after treatment was started. The predictive value for admission to the paediatric critical care units for a variety of cut offs for CRS at presentation were derived. RESULTS: A total of 112 children (70% male) of median age 12 months (IQR 2, 34.5 months) were enrolled. Patients with severe CRS (score 8–12) at presentation were more likely to be admitted to paediatric critical care (90% vs. 23% with mild-moderate CRS; OR: 5.7; 95% CI: 2.2–15.3, p < 0.001). The sensitivity and specificity of CRS > 3 in predicting outcome were 94% (95% CI 79.8–99.3) and 40% (95% CI 35–45), respectively, with a positive likelihood ratio of 1.6 (95% CI 1.31–1.98) and negative predictive value of 94% (95% CI 81–98). CONCLUSION: An admission CRS of > 3 in the ED of a Low-to Middle Income Country had excellent predictive value for disease severity, and it should be considered for incorporation into ED triage protocols. BioMed Central 2018-10-30 /pmc/articles/PMC6208017/ /pubmed/30376827 http://dx.doi.org/10.1186/s12887-018-1317-2 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Nayani, Kanwal Naeem, Rubaba Munir, Owais Naseer, Naureen Feroze, Asher Brown, Nick Mian, Asad I. The clinical respiratory score predicts paediatric critical care disposition in children with respiratory distress presenting to the emergency department |
title | The clinical respiratory score predicts paediatric critical care disposition in children with respiratory distress presenting to the emergency department |
title_full | The clinical respiratory score predicts paediatric critical care disposition in children with respiratory distress presenting to the emergency department |
title_fullStr | The clinical respiratory score predicts paediatric critical care disposition in children with respiratory distress presenting to the emergency department |
title_full_unstemmed | The clinical respiratory score predicts paediatric critical care disposition in children with respiratory distress presenting to the emergency department |
title_short | The clinical respiratory score predicts paediatric critical care disposition in children with respiratory distress presenting to the emergency department |
title_sort | clinical respiratory score predicts paediatric critical care disposition in children with respiratory distress presenting to the emergency department |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6208017/ https://www.ncbi.nlm.nih.gov/pubmed/30376827 http://dx.doi.org/10.1186/s12887-018-1317-2 |
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