Clin Exp Emerg Med.  2021 Dec;8(4):314-324. 10.15441/ceem.20.134.

A clinical prediction tool to predict urinary tract infection in pediatric febrile patients younger than 2 years old: a retrospective analysis of a fever registry

• Park YS
• Lee JH
• Kwak YH
• Jung JY
• Kwon H
• Choi YJ
• Suh DB
• Lee B
• Kim MJ
• Kim DK

• KMID: 2523852
• DOI: http://doi.org/10.15441/ceem.20.134

Abstract

Objective
Urinary tract infection (UTI) is a significant issue in young febrile patients due to potential long-term complications. Early detection of UTI is crucial in pediatric emergency departments (PEDs). We developed a tool to predict UTIs in children.
Methods
Clinical data of patients <24 months of age with a fever and UTI or viral infection were extracted from the fever registry collected in two PEDs. Stepwise multivariate logistic regression was performed to establish predictors of identified eligible clinical variables for the derivation of the prediction model.
Results
A total of 1,351 patients were included in the analysis, 643 patients from A hospital (derivation set) and 708 patients from B hospital (validation set). In the derivation set, there were more girls and a lower incidence of a past history of UTI, older age, less fever without source, and more family members with upper respiratory symptoms in the viral infection group. The stepwise regression analysis identified sex (uncircumcised male), age (≤12 months), a past history of UTI, and family members with upper respiratory symptoms as significant variables.
Conclusion
Young febrile patients in the PED were more likely to have UTIs if they were uncircumcised boys, were younger than 12 months of age, had a past history of UTIs, or did not have families with respiratory infections. This clinical prediction model may help determine whether to perform urinalysis in the PED.

Keyword

Infant; Urinary tract infections; Emergency service, hospital; Clinical decision rules