| Title |
Clinical features and inflammatory markers in pediatric pneumonia: a prospective study
|
|---|---|
| Published in |
European Journal of Pediatrics, March 2017
|
| DOI | 10.1007/s00431-017-2887-y |
| Pubmed ID | |
| Authors |
Are Stuwitz Berg, Christopher Stephen Inchley, Hans Olav Fjaerli, Truls Michael Leegaard, Morten Lindbaek, Britt Nakstad |
| Abstract |
In this prospective, observational study on previously healthy children <18 years, we aimed to study the diagnostic ability of clinical features and inflammatory markers to (i) predict pathologic chest radiography in suspected pneumonia and (ii) differentiate etiology in radiological proven pneumonia. In 394 cases of suspected pneumonia, 265 (67%) had radiographs consistent with pneumonia; 34/265 had proof of bacterial etiology. Of the cases, 86.5% had received pneumococcal conjugate vaccine. In suspected pneumonia, positive chest radiography was significantly associated with increasing C-reactive protein (CRP) values, higher age, and SpO2 ≤92% in multivariate logistic regression, OR 1.06 (95% CI 1.03 to 1.09), OR 1.09 (95% CI 1.00 to1.18), and OR 2.71 (95% CI 1.42 to 5.18), respectively. In proven pneumonia, bacterial pneumonia was significantly differentiated from viral/atypical pneumonia by increasing CRP values and SpO2 >92% in multivariate logistic regression, OR 1.09 (95% CI 1.05 to 1.14) and OR 0.23 (95% CI 0.06 to 0.82), respectively. Combining high CRP values (>80 mg/L) and elevated white blood cell (WBC) count provided specificity >85%, positive likelihood ratios >3, but sensitivity <46% for both radiographic proven and bacterial pneumonia. With relatively high specificity and likelihood ratio CRP, WBC count and hypoxemia may be beneficial in ruling in a positive chest radiograph in suspected pneumonia and bacterial etiology in proven pneumonia, but with low sensitivity, the clinical utility is limited. What is Known: • Pneumonia is recommended to be a clinical diagnosis, and neither clinical features nor inflammatory markers can reliably distinguish etiology. • The etiology of pneumonia has changed after routine pneumococcal conjugate vaccine. What is New: • High CRP and WBC counts were associated with infiltrates in children with suspected pneumonia and with bacterial infection in proven pneumonia. • In the post-pneumococcal vaccination era, viral etiology is expected, and in cases of pneumonia with low CRP and WBC counts, a watch-and-wait strategy for antibiotic treatment may be applied. |
X Demographics
The data shown below were collected from the profiles of 7 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 2 | 29% |
| Netherlands | 2 | 29% |
| Mexico | 1 | 14% |
| Unknown | 2 | 29% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 3 | 43% |
| Science communicators (journalists, bloggers, editors) | 2 | 29% |
| Practitioners (doctors, other healthcare professionals) | 1 | 14% |
| Scientists | 1 | 14% |
Mendeley readers
The data shown below were compiled from readership statistics for 92 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Canada | 1 | 1% |
| Unknown | 91 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 15 | 16% |
| Researcher | 10 | 11% |
| Student > Postgraduate | 8 | 9% |
| Student > Bachelor | 8 | 9% |
| Student > Doctoral Student | 6 | 7% |
| Other | 18 | 20% |
| Unknown | 27 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 41 | 45% |
| Unspecified | 5 | 5% |
| Nursing and Health Professions | 3 | 3% |
| Agricultural and Biological Sciences | 2 | 2% |
| Biochemistry, Genetics and Molecular Biology | 2 | 2% |
| Other | 8 | 9% |
| Unknown | 31 | 34% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 May 2017.
All research outputs
#6,849,129
of 22,958,253 outputs
Outputs from European Journal of Pediatrics
#1,305
of 3,740 outputs
Outputs of similar age
#109,453
of 307,900 outputs
Outputs of similar age from European Journal of Pediatrics
#16
of 54 outputs
Altmetric has tracked 22,958,253 research outputs across all sources so far. This one has received more attention than most of these and is in the 69th percentile.
So far Altmetric has tracked 3,740 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.7. This one has gotten more attention than average, scoring higher than 64% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 307,900 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 64% of its contemporaries.
We're also able to compare this research output to 54 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 68% of its contemporaries.