A5V4d

Clinical assessment of the child with fever
Table 5.57 − GRADE findings for evaluation of elevated heart rate
Table 5.57 − GRADE findings for evaluation of elevated heart rate
Table 5.53 GRADE profile for the distribution of age specific heart rate data by centile group for 1360 children
presenting at a paediatric emergency department with suspected serious bacterial infection for the detection of
serious illness
Number of studies Number of children Effect Quality
Total Children with
SBI
Relative
(95% confidence
interval)
Detection of serious illness using heart rate above 97 th centile
Absolute
(95%
confidence
interval)
1 (Brent, 2011) 28 1 OR 1.51 (0.19 to 12.0) - Very
low
Detection of serious illness using heart rate above 90 th centile
1 (Brent, 2011) 91 10 OR 5.04 (2.14 to 11.9) - Low
Detection of serious illness using heart rate above 75 th centile
1 (Brent, 2011) 199 12 OR 2.62 (1.19 to 5.79) - Low
Detection of serious illness using heart rate above 50 th centile
1 (Brent, 2011) 324 14 OR 1.85 (0.87 to 3.93) - Very
low
Detection of serious illness using heart rate below equal 50 th centile
1 (Brent, 2011) 586 14 OR 1.00 (Ref) - Low
Tachycardia
1 (Brent, 2011) 514 34 OR 2.90 (1.60 to 5.26) - Low
OR odds ratio, SBI serious bacterial infection
Table 5.54 GRADE profile for the sensitivity, specificity and positive and negative likelihood ratios for significant
bacterial infection of cut-offs defined by pulse centiles in 1360 children presenting at a paediatric emergency
department with suspected serious bacterial infection for the detection of serious illness
Number of
studies
Number of
children
Sensitivity
(95%
confidence
interval)
Specificity
(95%
confidence
interval)
Detection of serious illness using heart rate above 97 th centile
1 (Brent,
2011)
1360 2.0 (0.04 to
10.4)
97.7 (96.7 to
98.5)
Detection of serious illness using heart rate above 90 th centile
1 (Brent,
2011)
1360 21.6 (11.3
to 35.3)
90.8 (89.0 to
92.4)
Detection of serious illness using heart rate above 75 th centile
1 (Brent,
2011)
1360 45.1 (31.1
to 59.7)
75.7 (73.1 to
78.1)
Positive likelihood
ratio
(95% confidence
interval)
Negative likelihood
ratio
(95% confidence
interval)
Quality
2.7 (2.2 to 3.4) 0.96 (0.76 to 1.2) Low
2.4 (1.6 to 3.7) 0.86 (0.57 to 1.3) Low
1.7 (0.84 to 3.3) 0.78 (0.40 to 1.5) Low
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