The Yale Observation Scale Score and the Risk of Serious Bacterial Infections in Febrile Infants

• DOI: 10.1542/peds.2017-0695
• Publication Date: 2017-06-06T09:10:13Z
• Authors: Lise E. Nigrovic; Prashant V. Mahajan; Stephen M. Blumberg; Lorin R. Browne; James G. Linakis; Richard M. Ruddy; Jonathan E. Bennett; Alexander J. Rogers; Leah Tzimenatos; Elizabeth C. Powell; Elizabeth R. Alpern; T. Charles Casper; Octavio Ramilo; Nathan Kuppermann
• Keywords: Bacteremia

To assess the performance of Yale Observation Scale (YOS) score and unstructured clinician suspicion to identify febrile infants ≤60 days age with without serious bacterial infections (SBIs).We performed a planned secondary analysis prospective cohort non-critically ill, febrile, full-term presenting 1 26 participating emergency departments in Pediatric Emergency Care Applied Research Network. We defined SBIs as urinary tract infections, bacteremia, or meningitis, latter 2 considered invasive infections. department clinicians applied YOS (range: 6-30; normal score: ≤10) estimated risk SBI using (<1%, 1%-5%, 6%-10%, 11%-50%, >50%).Of 4591 eligible infants, 444 (9.7%) had 97 (2.1%) Of 4058 scores ≤10, 388 (9.6%) (sensitivity: 51/439 [11.6%]; 95% confidence interval [CI]: 8.8%-15.0%; negative predictive value: 3670/4058 [90.4%]; CI: 89.5%-91.3%) 72 (1.8%) (sensitivity 23/95 [24.2%], 16.0%-34.1%; 3983/4055 [98.2%], 97.8%-98.6%). <1%, 106 (6.4%) 16 (1.0%) infections.In this large age, neither nor reliably identified those More accurate clinical laboratory predictors are needed stratify infants.