Prospective evaluation of a model of prediction of invasive bacterial infection risk among children with cancer, fever, and neutropenia.
A risk prediction model for invasive bacterial infection (IBI) was prospectively evaluated among children presenting with cancer, fever, and neutropenia. The model incorporated assessment of 5 previously identified risk factors: serum level of C-reactive protein (CRP) >/=90 mg/L, hypotension, identification of relapse of leukemia as the cancer type, platelet count of </=50,000 platelets/mm(3), and recent receipt of chemotherapy [16]. Children were uniformly evaluated at enrollment and were classified as having high or low risk for IBI according to a model that considers the number and type of variables present. Of the 263 febrile episodes evaluated during a 17-month period, 140 (53%) were in IBI-positive children. The sensitivity, specificity, and positive and negative predictive values of the model were 92%, 76%, 82%, and 90%, respectively. Identification of these 5 risk factors during the first 24 h of hospitalization was helpful in discriminating between children with a high or low risk for IBI.
Department of Pediatrics, Hospital Luis Calvo Mackenna, and Subcommittee of Infectious Disease, National Child Program of Antineoplastic Drugs, Santiago, Chile. msantola@machi.med.uchile.cl
M E
ME
Santolaya
A M
AM
Alvarez
C L
CL
Avilés
A
A
Becker
J
J
Cofré
N
N
Enríquez
M
M
O'Ryan
E
E
Payá
C
C
Salgado
P
P
Silva
J
J
Tordecilla
M
M
Varas
M
M
Villarroel
T
T
Viviani
M
M
Zubieta
D000293:Adolescent; D001424:Bacterial Infections / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005334:Fever / Q000209:etiology*; D006801:Humans; D015233:Models, Statistical; D009369:Neoplasms / Q000150:complications*; D009503:Neutropenia / Q000209:etiology*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors