C-Reactive Protein Level as Diagnostic Marker in Young Febrile Children Presenting in a General Practice Out-of-Hours Service
© Copyright 2016 by the American Board of Family Medicine..
BACKGROUND: It is unclear how well a C-reactive protein (CRP) value predicts a serious infection (SI) in young febrile children in general practice.
METHODS: This prospective cohort study with 1-week follow-up included children, aged 3 months to 6 years, presenting with fever to a general practitioner out-of-hours service. We evaluate whether CRP level has predictive value for diagnosing a child at risk for an SI either at presentation or during follow-up. The index test was CRP ≤20 mg/L (rule out an SI) and >80 mg/L (rule in an SI). The reference standard was referral to a pediatric emergency department or diagnosis of an SI. The main outcome measure was CRP value.
RESULTS: CRP level was available for 440 children. To rule out an SI, CRP ≤20 mg/L did not change the probability of having no SI (87.5%). CRP >80 mg/L increased the probability of having an SI from 11.4% (pretest probability) to 21.2% (posttest probability). In children without a diagnosis of SI at presentation, CRP could not predict an SI during follow-up (CRP >80 mg/L: positive likelihood ratio, 2.1, 95% confidence interval, 1.3-3.5; CRP ≤20 mg/L: negative likelihood ratio, 0.9, 95% confidence interval, 0.7-1.2).
CONCLUSIONS: In general practice CRP has little clinically relevant value in discriminating febrile children in need of medical care from those who are not.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2016 |
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| Erschienen: |
2016 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
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| Enthalten in: |
Journal of the American Board of Family Medicine : JABFM - 29(2016), 4 vom: 01. Juli, Seite 460-8 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kool, Marijke [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 09.11.2017 Date Revised 30.03.2022 published: Print Citation Status MEDLINE |
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| doi: |
10.3122/jabfm.2016.04.150315 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM26217734X |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Copyright 2016 by the American Board of Family Medicine. | ||
| 520 | |a BACKGROUND: It is unclear how well a C-reactive protein (CRP) value predicts a serious infection (SI) in young febrile children in general practice | ||
| 520 | |a METHODS: This prospective cohort study with 1-week follow-up included children, aged 3 months to 6 years, presenting with fever to a general practitioner out-of-hours service. We evaluate whether CRP level has predictive value for diagnosing a child at risk for an SI either at presentation or during follow-up. The index test was CRP ≤20 mg/L (rule out an SI) and >80 mg/L (rule in an SI). The reference standard was referral to a pediatric emergency department or diagnosis of an SI. The main outcome measure was CRP value | ||
| 520 | |a RESULTS: CRP level was available for 440 children. To rule out an SI, CRP ≤20 mg/L did not change the probability of having no SI (87.5%). CRP >80 mg/L increased the probability of having an SI from 11.4% (pretest probability) to 21.2% (posttest probability). In children without a diagnosis of SI at presentation, CRP could not predict an SI during follow-up (CRP >80 mg/L: positive likelihood ratio, 2.1, 95% confidence interval, 1.3-3.5; CRP ≤20 mg/L: negative likelihood ratio, 0.9, 95% confidence interval, 0.7-1.2) | ||
| 520 | |a CONCLUSIONS: In general practice CRP has little clinically relevant value in discriminating febrile children in need of medical care from those who are not | ||
| 650 | 4 | |a Evaluation Study | |
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Berger, Marjolein Y |e verfasserin |4 aut | |
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