A5V4d

Number of
studies
Number of
children
Sensitivity
(95%
confidence
interval)
Specificity
(95%
confidence
interval)
Clinical assessment of the child with fever
Positive
likelihood ratio
(95% confidence
interval)
Detection of serious illness using heart rate and temperature above 50 th centile
1 (Brent et al.,
2011)
Tachycardia
1 (Brent et al.,
2011)
1360 74.5 (60.4 to
85.7)
1360 66.7 (52.1 to
79.2)
36.2 (33.4 to
39.0)
59.2 (56.3 to
62.0)
Negative
likelihood ratio
(95% confidence
interval)
Quality
1 (0.50 to 2.6) 0.75 (0.33 to 1.7) Low
1.5 (0.67 to 3.4) 0.65 (0.29 to 1.46) Low
Table 5.61 GRADE profile for the sensitivity of cut-offs defined by heart rate and body temperature centiles and
tachycardia for detecting children with meningococcal septicaemia of various degrees of severity in 325 children
presenting to hospital with meningitis
Number of studies Total number
of children
Sensitivity
(95% confidence interval)
All children with
meningococcal septicaemia
Detection of serious illness using heart rate and temperature above 97 th centile
1 (Brent et al.,
2011)
Children with severe
disease on admission
325 23.6 (18.5 to 29.3) 33.3 (22.9 to 45.2) Low
Detection of serious illness using heart rate and temperature above 90 th centile
1 (Brent et al.,
2011)
325 37.8 (31.8 to 44.1) 50.7 (38.9 to 62.4) Low
Detection of serious illness using heart rate and temperature above 75 th centile
1 (Brent et al.,
2011)
325 55.5 (49.2 to 61.7) 62.7 (50.7 to 73.6) Low
Detection of serious illness using heart rate and temperature above 50 th centile
1 (Brent et al.,
2011)
325 70.1 (64.0 to 75.6) 74.7 (63.3 to 84.0) Low
Detection of serious illness using heart rate and temperature below 50 th centile
1 (Brent et al.,
2011)
325 29.9 (24.4 to 36.0) 25.3 (16.0 to 36.7) Low
Evidence statements
How heart rate changes with temperature
Three studies (one retrospective and two prospective) evaluated how heart rate changes with
temperature in children with self-limiting infections. The studies reported that heart rate increased
approximately 10 bpm with each 1 º C increment in temperature. The studies were of low quality.
Using changes in heart rate alone to detect serious illness
Three prospective observational studies examined if heart rate could be used to identify children with
bacterial infection, and to differentiate between serious and non-serious infection. The studies
Quality
123
2013 Update