Severe bandemia is not associated with increased risk for adverse events in general pediatric emergency department patients
Severe bandemia is not associated with increased risk for adverse events in general pediatric emergency department patients
ABSTRACT BackgroundThe presence of band cells >10% of the total white blood cell (WBC) count (“bandemia”) is often used as an indicator of serious bacterial illness (SBI). Results from studies of bandemia as a predictor of SBI were conflicting and little is known about the relationship between severe bandemia (SB) and clinical outcomes from SBI in children. ObjectivesIn this retrospective patient-centered study, we hypothesized that SB (band level >20%) is not associated with adverse outcomes in an emergency department (ED) pediatric population. MethodsMedical records from children between the ages of 2 months and 18 years with SB who presented to a tertiary referral regional hospital were studied. Outcomes were categorized as severe adverse events (SAEs) or moderate adverse events (MAEs). Multivariate logistic regressions were used to assess the association between SB and outcomes. ResultsWe analyzed 102 patients. Mean age (standard deviation [SD]) was 5.25(0.5) years, 18 (18%) had MAE, 21 (21%) had SAE, and no patients died. Mean band levels were similar between groups: no adverse events [28 (10)] vs. SAE [31 (9)] vs. MAE [27(8)], p=0.64. Multivariate logistic regressions showed SB was not associated with any adverse events (odds ratio [OR] 1.04, 95% confidence interval [CI] 0.9-1.1, p=0.27). Non-normal X-ray (XR) (OR 17, 95% CI 3.3-90, p<0.001) was associated with MAE, while non-normal computerized tomography (CT) scan (OR 15.4, 95% CI 2.2-100+, p=0.002) was associated with SAE. ConclusionSevere bandemia was not associated with higher odds of adverse events among the general ED pediatric population. Clinicians should base their clinical judgment on the overall context of history, physical examinations, and other laboratory and imaging data.
Afridi Leenah、Berman Emilie、Karwoski Allison、Kaur Norvir、Abdalla Norhan、Sahadzic Iana、Solomon Juliana、Tran Quincy K、Yardi Isha、Afridi Ikram、Najafali Daniel、Cao Tiffany T
University of Maryland School of Medicine, The Research Associate Program in Emergency Medicine and Critical CareUniversity of Maryland School of Medicine, The Research Associate Program in Emergency Medicine and Critical CareUniversity of Maryland School of Medicine, Department of Emergency MedicineUniversity of Maryland School of Medicine, The Research Associate Program in Emergency Medicine and Critical CareUniversity of Maryland School of Medicine, The Research Associate Program in Emergency Medicine and Critical CareUniversity of Maryland School of Medicine, The Research Associate Program in Emergency Medicine and Critical CareUniversity of Maryland School of Medicine, The Research Associate Program in Emergency Medicine and Critical CareUniversity of Maryland School of Medicine, Department of Emergency Medicine||University of Maryland School of Medicine, The R Adams Cowley Shock Trauma CenterUniversity of Maryland School of Medicine, The Research Associate Program in Emergency Medicine and Critical CareUniversity of Maryland School of Medicine, The Research Associate Program in Emergency Medicine and Critical CareUniversity of Maryland School of Medicine, The Research Associate Program in Emergency Medicine and Critical CareUniversity of Maryland School of Medicine, The Research Associate Program in Emergency Medicine and Critical Care
儿科学医学研究方法基础医学
Adverse outcomeBacterial illnessBandemiaGeneral pediatric emergency department patientsSevere bandemia
Afridi Leenah,Berman Emilie,Karwoski Allison,Kaur Norvir,Abdalla Norhan,Sahadzic Iana,Solomon Juliana,Tran Quincy K,Yardi Isha,Afridi Ikram,Najafali Daniel,Cao Tiffany T.Severe bandemia is not associated with increased risk for adverse events in general pediatric emergency department patients[EB/OL].(2025-03-28)[2025-04-25].https://www.medrxiv.org/content/10.1101/2020.12.28.20248556.点此复制
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