Skip to main content

Advertising Disclaimer »

Main menu

  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors/Reviewers
    • Submit Manuscript
    • Author Guidelines
    • Reviewer Guidelines
    • Editorial Policies
    • Open Access
  • Content
    • Current Issue
    • Online First
    • Archive
    • Topic/Program Collections
    • Blog
  • Subscribe
  • Alerts
  • Careers
  • Other Publications
    • American Academy of Pediatrics

User menu

  • Log in
  • My Cart

Search

  • Advanced search
American Academy of Pediatrics

AAP Gateway

Advanced Search

AAP Logo

  • Log in
  • My Cart
  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors/Reviewers
    • Submit Manuscript
    • Author Guidelines
    • Reviewer Guidelines
    • Editorial Policies
    • Open Access
  • Content
    • Current Issue
    • Online First
    • Archive
    • Topic/Program Collections
    • Blog
  • Subscribe
  • Alerts
  • Careers
American Academy of Pediatrics
Research Articles

External Validation of an Invasive Bacterial Infection Score for Young Febrile Infants

Stacy J. Tsai and Sriram Ramgopal
Hospital Pediatrics February 2021, hpeds.2020-003178; DOI: https://doi.org/10.1542/hpeds.2020-003178
Stacy J. Tsai
aFeinberg School of Medicine, Northwestern University, Chicago, Illinois; and
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sriram Ramgopal
aFeinberg School of Medicine, Northwestern University, Chicago, Illinois; and
bDivision of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • Comments
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Download PDF

Abstract

OBJECTIVES: The Aronson rule is a point-based clinical decision rule for the identification of febrile infants ≤60 days of age at low risk of invasive bacterial infection (IBI) in the emergency department. This rule uses variables of temperature, age, urinalysis, and absolute neutrophil count. We sought to externally validate this decision rule.

METHODS: We conducted a secondary analysis of a multicenter prospective cohort of febrile infants ≤60 days old presenting to the emergency department between December 2008 and May 2013. Infants were excluded if they had clinical sepsis or chronic conditions or were missing any laboratory components of the Aronson score. Our outcome was IBI (bacteremia and/or bacterial meningitis). We assessed the accuracy of the Aronson rule by reporting metrics of diagnostic accuracy with 95% confidence intervals (CIs) at different point thresholds.

RESULTS: Of 4130 included patients (780 <21 days of age; 2362 boys), 87 (2.1%) had an IBI, including 65 with isolated bacteremia and 22 with meningitis. Using an Aronson cutoff score of 2 resulted in a sensitivity of 93.1% (95% CI 85.6%–97.4%), specificity of 26.6% (95% CI 25.3%–28.0%), and negative predictive value of 99.4% (95% CI 98.8%–99.8%). Six patients with IBI (3 with bacterial meningitis) were misclassified as low risk when using a threshold of 2.

CONCLUSIONS: The Aronson rule demonstrates metrics of diagnostic accuracy that are comparable to the derivation study. Our findings suggest that the rule may be generalizable for the risk stratification of well-appearing febrile infants.

  • Copyright © 2021 by the American Academy of Pediatrics
View Full Text

Individual Login

Log in
You will be redirected to aap.org to login or to create your account.

Institutional Login

via Institution

You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.

Log in through your institution

If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.

Purchase access

You may purchase access to this article. This will require you to create an account if you don't already have one.

Offer Reprints

PreviousNext
Back to top

Advertising Disclaimer »

In this issue

Hospital Pediatrics: 11 (3)
Hospital Pediatrics
Vol. 11, Issue 3
1 Mar 2021
  • Table of Contents
  • Table of Contents (PDF)
  • Index by author
View this article with LENS
PreviousNext
Email Article

Thank you for your interest in spreading the word on American Academy of Pediatrics.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
External Validation of an Invasive Bacterial Infection Score for Young Febrile Infants
(Your Name) has sent you a message from American Academy of Pediatrics
(Your Name) thought you would like to see the American Academy of Pediatrics web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Request Permissions
Article Alerts
Log in
You will be redirected to aap.org to login or to create your account.
Or Sign In to Email Alerts with your Email Address
Citation Tools
External Validation of an Invasive Bacterial Infection Score for Young Febrile Infants
Stacy J. Tsai, Sriram Ramgopal
Hospital Pediatrics Feb 2021, hpeds.2020-003178; DOI: 10.1542/hpeds.2020-003178

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
External Validation of an Invasive Bacterial Infection Score for Young Febrile Infants
Stacy J. Tsai, Sriram Ramgopal
Hospital Pediatrics Feb 2021, hpeds.2020-003178; DOI: 10.1542/hpeds.2020-003178
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
Print
Download PDF
Insight Alerts

Jump to section

  • Article
    • Abstract
    • Methods
    • Results
    • Discussion
    • Conclusions
    • Footnotes
    • References
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • Comments

Related Articles

  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Improving Pediatric Resident Safety Event Reporting Using Quality Improvement Methods
  • Quality Improvement Approach to Reducing Admission Hypothermia Among Preterm and Term Infants
  • Effects of a Poetry Intervention on Emotional Wellbeing in Hospitalized Pediatric Patients
Show more Research Articles

Similar Articles

Subjects

  • Hospital Medicine
    • Hospital Medicine
  • Emergency Medicine
    • Emergency Medicine
  • Journal Info
  • Editorial Board
  • Editorial Policies
  • Overview
  • Licensing Information
  • Authors/Reviewers
  • Author Guidelines
  • Reviewer Guidelines
  • Submit My Manuscript
  • Open Access
  • Librarians
  • Institutional Subscriptions
  • Usage Stats
  • Support
  • Subscribe
  • Contact Us
  • Resources
  • Media Kit
  • About
  • International Access
  • Terms of Use
  • Privacy Statement
  • FAQ
  • RSS Feeds
  • shopAAP
  • AAP.org
  • Follow American Academy of Pediatrics on Instagram
  • Visit American Academy of Pediatrics on Facebook
  • Follow American Academy of Pediatrics on Twitter
  • Follow American Academy of Pediatrics on Youtube
American Academy of Pediatrics

© 2021 American Academy of Pediatrics