TY - JOUR
T1 - Predictors and outcome of admission for invasive Streptococcus pneumoniae infections at a Canadian Children's Hospital
AU - Laupland, Kevin B.
AU - Davies, H. Dele
AU - Kellner, James D.
AU - Luzod, Nina Lynn
AU - Karan, Tulika
AU - Ma, Doreen
AU - Taub, Dina
AU - Nijssen-Jordan, Cheri
AU - Katzko, Gary
AU - Jadavji, Taj
AU - Church, Deirdre
N1 - Funding Information:
Received 2 December 1997; revised 31 March 1998. This work was presented in part at the 37th Interscience Conference on Antimicrobial Agents and Chemotherapy held on 28 September–1 October 1997 in Toronto [abstracts K-98 and K-99]. Financial support: H. D. D. was supported through a Clinical Investiga-torship Award of the Alberta Heritage Foundation for Medical Research. Reprints or correspondence: Dr. H. Dele Davies, Child Health Research Unit, Room 2271, Alberta Children’s Hospital, 1820 Richmond Road, S.W., Calgary, Alberta, Canada T2T 5C7.
PY - 1998
Y1 - 1998
N2 - Rates of admission for invasive Streptococcus pneumoniae infection in children vary considerably between institutions. We performed a retrospective study to investigate factors used in the decision to admit patients with invasive S. pneumoniae infection to Alberta Children's Hospital. Of 254 patients who were initially assessed in the emergency department, 38.2% were admitted to the hospital. Significant risk factors for admission as determined by a logistic regression model included murmur (odds ratio [OR], 18.98; 95% confidence interval [CI], 4.08-88.23), focal infection (OR, 11.41; 95% CI, 5.07-25.67), and older age (OR, 2.72; 95% CI, 1.03-7.17). Higher hemoglobin level (OR, 0.96; 95% CI, 0.93-0.99) and temperature of >38.5°C (OR, 0.39; 95% CI, 0.18-0.85) were associated with a lower risk of admission. Two patients died (case-fatality rate, 0.7%). Despite the low rate of admission for invasive S. pneumoniae infections at our hospital, the mortality rate was comparable with those at institutions with higher rates of admission, thus suggesting that the factors we identified may be useful in deciding whether to admit patients with (or who are at high risk for) invasive S. pneumoniae infections.
AB - Rates of admission for invasive Streptococcus pneumoniae infection in children vary considerably between institutions. We performed a retrospective study to investigate factors used in the decision to admit patients with invasive S. pneumoniae infection to Alberta Children's Hospital. Of 254 patients who were initially assessed in the emergency department, 38.2% were admitted to the hospital. Significant risk factors for admission as determined by a logistic regression model included murmur (odds ratio [OR], 18.98; 95% confidence interval [CI], 4.08-88.23), focal infection (OR, 11.41; 95% CI, 5.07-25.67), and older age (OR, 2.72; 95% CI, 1.03-7.17). Higher hemoglobin level (OR, 0.96; 95% CI, 0.93-0.99) and temperature of >38.5°C (OR, 0.39; 95% CI, 0.18-0.85) were associated with a lower risk of admission. Two patients died (case-fatality rate, 0.7%). Despite the low rate of admission for invasive S. pneumoniae infections at our hospital, the mortality rate was comparable with those at institutions with higher rates of admission, thus suggesting that the factors we identified may be useful in deciding whether to admit patients with (or who are at high risk for) invasive S. pneumoniae infections.
UR - http://www.scopus.com/inward/record.url?scp=17344364735&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=17344364735&partnerID=8YFLogxK
U2 - 10.1086/514707
DO - 10.1086/514707
M3 - Article
C2 - 9770162
AN - SCOPUS:17344364735
SN - 1058-4838
VL - 27
SP - 597
EP - 602
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 3
ER -