■发热婴儿有严重细菌感染(SBI)的风险,可能会危及生命。本研究旨在调查发热婴儿中延迟呈递与SBIs风险之间的关系。
我们在2017年11月至2022年7月期间对新加坡儿科急诊科(ED)就诊的≤90天发热婴儿进行了前瞻性队列研究。我们将延迟呈现定义为从发烧开始>24小时到ED的呈现。我们比较了出现延迟的婴儿与没有出现延迟的婴儿的SBI比例,和他们的临床结果。我们还进行了多变量逻辑回归,以研究延迟呈现是否与SBI的存在独立相关。
■在分析的1911名发热婴儿中,198名婴儿(10%)出现延迟。出现延迟的发热婴儿更有可能患有SBIs(28.8%对[vs]16.3%,P<0.001)。延迟就诊的婴儿需要静脉注射抗生素的比例较高(64.1%vs51.9%,P=0.001)。在调整了年龄之后,性别和严重程度指数评分,延迟提示与SBI的存在独立相关(校正比值比[AOR]1.78,95%置信区间1.26~2.52,P<0.001).
■出现延迟的发热婴儿发生SBI的风险较高。一线临床医生在评估发热婴儿时应考虑到这一点。
UNASSIGNED: Febrile young infants are at risk of serious bacterial infections (SBIs), which are potentially life-threatening. This
study aims to investigate the association between delayed presentation and the risk of SBIs among febrile infants.
UNASSIGNED: We performed a prospective cohort
study on febrile infants ≤90 days old presenting to a Singapore paediatric emergency department (ED) between November 2017 and July 2022. We defined delayed presentation as presentation to the ED >24 hours from fever onset. We compared the proportion of SBIs in infants who had delayed presentation compared to those without, and their clinical outcomes. We also performed a multivariable logistic regression to
study if delayed presentation was independently associated with the presence of SBIs.
UNASSIGNED: Among 1911 febrile infants analysed, 198 infants (10%) had delayed presentation. Febrile infants with delayed presentation were more likely to have SBIs (28.8% versus [vs] 16.3%, P<0.001). A higher proportion of infants with delayed presentation required intravenous antibiotics (64.1% vs 51.9%, P=0.001). After adjusting for age, sex and severity index score, delayed presentation was independently associated with the presence of SBI (adjusted odds ratio [AOR] 1.78, 95% confidence interval 1.26-2.52, P<0.001).
UNASSIGNED: Febrile infants with delayed presentation are at higher risk of SBI. Frontline clinicians should take this into account when assessing febrile infants.