Amir Hosein Jafari Rouhi
1*, Yousef Nouri
2, Mohammad Hasan Kargar Maher
3, Mohammad Ahangarzadeh Rezaee
4, Shahram Abdoli Oskouei
3, Ali Reza Nikniyaz
31 Child Health Research Center, Departments of Emergency Medicine and Pediatrics, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
2 School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
3 Child Health Research Center, Department of Pediatrics, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
4 Infectious Disease and Tropical Medicine Research Center, Department of Microbiology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
Abstract
Backgrounds and Objectives: Bacteremia in children should be diagnosed and treated as soon as possible. Yale observational scale (YOS) is one of this scales which there are controversy against its usefulness. Current study evaluates diagnostic significance of YOS in determining bacteremia in febrile inpatients aged 3-36 months. Materials and Methods: In this cross-sectional study, 112 febrile hospitalized patients aged 3-36 months (mean age 16.65±9.92 months) visiting emergency department was studied. Before giving antipyretics and antibiotics rectal temperature was recorded and Blood cultures were taken in all children. YOS score and culture results were recorded in all patients. ROC curve for YOS was plotted and its sensitivity, specificity, positive and negative predictive value (PPV and NPV), likelihood ratio (LR) in diagnosing bacteremia were calculated. Results: Bacteremia was detected in 14.3% of patients. Children with bacteremia had significantly higher body temperature (39.34±0.35 versus 39.04±0.36, p<0.001) and YOS score (20.87±4.31 versus 12.70±4.36, p<0.001). Sensitivity, specificity, PPV, NPV, positive LR and negative LR for YOS of greater than 15 were 81%, 71%, 32%, 96%, 2.79 and 0.26, respectively. Sensitivity and specificity for BT of higher than 39.25 in diagnosing bacteremia were 56% and 72% respectively. Conclusion: YOS is a simple and easy to administer and has acceptable sensitivity to predict bacteremia; however because of low specificity we could not completely rely on this scale.