Van den Bruel et al performed a classification and regression tree (CART) analysis of pediatric patients presenting acutely in primary practice. This can help to identify subsets of patients who are more likely to have a serious medical condition. The authors are from Katholieke Universiteit (Leuven, Belgium), Universiteit Hasselt (Diepenbeek, Belgium) and Universiteit Maastricht (Maastricht, the Netherlands).
Patient selection: age <= 16 years and sick for up to a maximum of 5 days at presentation
Prevalence of serious illness in the population (3,981 patients): 0.8%
Parameters:
(1) physician thinks that something looks wrong with the patient
(2) dyspnea
(3) temperature
(4) diarrhea
(5) age in years
Something Wrong
Dyspnea
Temp in °C
Diarrhea
Age in Years
Percent Serious
Y
NA
NA
NA
NA
15%
N
Y
NA
NA
NA
3.4%
N
N
>= 40°C
NA
NA
2%
N
N
< 40°C
Y
< 1.18
0%
N
N
< 40°C
Y
1.18 to 2.42
3%
N
N
< 40°C
Y
> 2.42
0%
N
N
< 40°C
N
NA
0.033%
where:
• The cutoff for temperature was > 39.95°C which is interpreted as >= 40°C (>= 104°F).
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