Analysis of nice “traffic light” system’s “amber” zone symptoms importance when suspecting serious bacterial infection in febrile children less than 5 years

Abstract

Introduction Febrile illnesses are one of the most common reasons for young children to present to primary care practitioners and may account for up to a third of presentations to emergency departments [1]. Depending on the setting, about 5–25% of fever episodes in young children are due to serious bacterial infections (SBI) [2]. The UK National Institute for Health and Clinical Excellence (NICE) published a guideline which provides a “traffic light” system for the initial assessment and management of young children with fever. Children whose clinical features fall within the „green“ zone are considered to be at low risk of serious illness, while those in the „amber“ and „red“ zones are at intermediate and high risk respectively [3]. Although it has been widely promulgated, the accuracy of this system’s “amber” zone criteria for the detection of serious bacterial infections has not been validated to date. Aim To evaluate the importance of “traffic light” system’s “amber” zone symptoms, when suspecting SBI in febrile children less than 5 years Objectives 1. Determine the frequencies of clinical diagnoses among febrile children whit amber zone symptoms. 2. Identify the association between „amber“ zone symptoms and SBI. 3. Compare the total number of „amber“ zone symptoms between SBI and other febrile disease group. Methods 1. A prospective study of febrile children under 5 years of age who were admitted to KK LHUS pediatric emergency department was performed. The diagnoses of ambulatory patients were verified by home phone calls. The study lasted from January 1, 2014 to April 1, 2014. 2. NICE “traffic light” system was implemented to the study. The system groups febrile children into 3 categories according to the probability of SBI: “green”,”amber”, ”red”. 3. Study inclusion criteria: ≤5 years of age, axillary temperature ≥38°C measured at pediatric.[...].