TY - JOUR
T1 - Validity of the quick-read C-reactive protein test in the prediction of bacterial pneumonia in the pediatric emergency department
AU - Marcus, Nufar
AU - Mor, Meirav
AU - Amir, Lisa
AU - Mimouni, Marc
AU - Waisman, Yehezkel
PY - 2008/6
Y1 - 2008/6
N2 - BACKGROUND: C-reactive protein (CRP) values are clinically useful in differentiating viral from bacterial illnesses in children, but the regular test is impractical in the emergency department (ED) setting. OBJECTIVE: To investigate the validity and feasibility of the 2-min bedside Quick Read (QR)-CRP test in the prediction of bacterial pneumonia in children in the ED. METHODS: Fifty randomly selected children aged 4 days to 17 years, who presented to a pediatric ED with symptoms and signs of pneumonia over a 6-month period, were prospectively studied. The diagnosis of bacterial/viral pneumonia was based on clinical and radiological findings. CRP was measured in leftover blood (0.2 ml) using the QR-CRP kit. Clinical and laboratory data were statistically analyzed against CRP values for ability to predict bacterial pneumonia. RESULTS: Thirty-six patients (72%) were diagnosed with bacterial pneumonia and 14 (28%) with viral pneumonia; mean CRP levels were 121.3±122 and 27.2±26 mg/l, respectively (P=0.007). Significantly higher CRP levels were associated with bacterial than with viral pneumonia in the patients who presented before 96 h of symptom onset (P=0.013-0.028), but not in those who presented later. On receiver operating characteristics analysis, CRP was a better indicator of a chest radiograph picture of bacterial pneumonia (area under the curve=0.79) than absolute neutrophil count (0.78) or white blood cell count (0.73). Combining all three parameters yielded an area of 0.865. CONCLUSION: The QR-CRP test seems to be an useful predictor of bacterial pneumonia in children, especially those with a shorter illness duration, and is feasible for use in the ED.
AB - BACKGROUND: C-reactive protein (CRP) values are clinically useful in differentiating viral from bacterial illnesses in children, but the regular test is impractical in the emergency department (ED) setting. OBJECTIVE: To investigate the validity and feasibility of the 2-min bedside Quick Read (QR)-CRP test in the prediction of bacterial pneumonia in children in the ED. METHODS: Fifty randomly selected children aged 4 days to 17 years, who presented to a pediatric ED with symptoms and signs of pneumonia over a 6-month period, were prospectively studied. The diagnosis of bacterial/viral pneumonia was based on clinical and radiological findings. CRP was measured in leftover blood (0.2 ml) using the QR-CRP kit. Clinical and laboratory data were statistically analyzed against CRP values for ability to predict bacterial pneumonia. RESULTS: Thirty-six patients (72%) were diagnosed with bacterial pneumonia and 14 (28%) with viral pneumonia; mean CRP levels were 121.3±122 and 27.2±26 mg/l, respectively (P=0.007). Significantly higher CRP levels were associated with bacterial than with viral pneumonia in the patients who presented before 96 h of symptom onset (P=0.013-0.028), but not in those who presented later. On receiver operating characteristics analysis, CRP was a better indicator of a chest radiograph picture of bacterial pneumonia (area under the curve=0.79) than absolute neutrophil count (0.78) or white blood cell count (0.73). Combining all three parameters yielded an area of 0.865. CONCLUSION: The QR-CRP test seems to be an useful predictor of bacterial pneumonia in children, especially those with a shorter illness duration, and is feasible for use in the ED.
KW - Bacterial
KW - C-reactive protein
KW - Children
KW - Diagnosis
KW - Emergency department
KW - Pneumonia
KW - Point-of-care testing
KW - Viral
UR - http://www.scopus.com/inward/record.url?scp=43149098492&partnerID=8YFLogxK
U2 - 10.1097/MEJ.0b013e3282f12f52
DO - 10.1097/MEJ.0b013e3282f12f52
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AN - SCOPUS:43149098492
SN - 0969-9546
VL - 15
SP - 158
EP - 161
JO - European Journal of Emergency Medicine
JF - European Journal of Emergency Medicine
IS - 3
ER -