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dc.contributor.authorInchley, Christopher
dc.contributor.authorFjærli, Hans Olav
dc.contributor.authorLeegaard, Truls Michael
dc.contributor.authorLindbæk, Morten
dc.contributor.authorNakstad, Britt
dc.date.accessioned2019-10-24T12:12:06Z
dc.date.available2019-10-24T12:12:06Z
dc.date.issued2017-03-09
dc.identifier.citationBerg, A. S., Inchley, C. S., Fjaerli, H. O., Leegaard, T. M., Lindbaek, M., & Nakstad, B. (2017). Clinical features and inflammatory markers in pediatric pneumonia: a prospective study. European journal of pediatrics, 176(5), 629-638.en
dc.identifier.issn0340-6199
dc.identifier.urihttps://hdl.handle.net/10642/7771
dc.description.abstractAbstract 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. Conclusion: 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.en
dc.language.isoenen
dc.publisherSpringeren
dc.relation.ispartofseriesEuropean journal of pediatrics;176(5)
dc.rightsThis is a post-peer-review, pre-copyedit version of an article published in European Journal of Pediatrics .The final authenticated version is available online at: http://dx.doi.org/10.1007/s00431-017-2887-yen
dc.titleClinical features and inflammatory markers in pediatric pneumonia: a prospective studyen
dc.typeJournal articleen
dc.typePeer revieweden
dc.description.versionacceptedVersionen
dc.identifier.doihttp://dx.doi.org/10.1007/s00431-017-2887-y
dc.identifier.cristin1475489


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