2018
Risk Stratification of Febrile Infants ≤60 Days Old Without Routine Lumbar Puncture
Aronson PL, Wang ME, Shapiro ED, Shah SS, DePorre AG, McCulloh RJ, Pruitt CM, Desai S, Nigrovic LE, Marble RD, Leazer RC, Rooholamini SN, Sartori LF, Balamuth F, Woll C, Neuman MI. Risk Stratification of Febrile Infants ≤60 Days Old Without Routine Lumbar Puncture. Pediatrics 2018, 142: e20181879. PMID: 30425130, PMCID: PMC6317769, DOI: 10.1542/peds.2018-1879.Peer-Reviewed Original ResearchConceptsInvasive bacterial infectionsPhiladelphia criteriaFebrile infantsBacterial meningitisRisk stratificationCSF testingRochester criteriaEmergency departmentLower riskRoutine CSF testingCerebrospinal fluid testingComplex chronic conditionsRoutine lumbar punctureCase-control studyDate of visitLow-risk infantsLumbar punctureChronic conditionsHigh riskInfantsBacterial infectionsDay oldsFluid testingMeningitisRisk
2015
Association between Clinical Outcomes and Hospital Guidelines for Cerebrospinal Fluid Testing in Febrile Infants Aged 29-56 Days
Chua KP, Neuman MI, McWilliams JM, Aronson PL, Collaborative F, Thurm C, Williams D, Browning W, Nigrovic L, Alpern E, Tieder J, Feldman E, Shah S, Schondelmeyer A, Alessandrini E, McCulloh R, Myers A, Balamuth F, Hayes K. Association between Clinical Outcomes and Hospital Guidelines for Cerebrospinal Fluid Testing in Febrile Infants Aged 29-56 Days. The Journal Of Pediatrics 2015, 167: 1340-1346.e9. PMID: 26477870, PMCID: PMC5535778, DOI: 10.1016/j.jpeds.2015.09.021.Peer-Reviewed Original ResearchConceptsClinical practice guidelinesOlder febrile infantsFebrile infantsCerebrospinal fluid testingClinical outcomesCSF testingAdverse eventsFluid testingYoung febrile infantsCentral venous cathetersUS children's hospitalsSignificant differencesMedian annual household incomeRace/ethnicityAnnual household incomeHospital mortalityVenous cathetersBacterial meningitisMembrane oxygenationPrimary outcomeHospital guidelinesMechanical ventilationChildren's HospitalEmergency departmentPractice guidelinesAssociation of clinical practice guidelines with emergency department management of febrile infants ≤56 days of age
Aronson PL, Thurm C, Williams DJ, Nigrovic LE, Alpern ER, Tieder JS, Shah SS, McCulloh RJ, Balamuth F, Schondelmeyer AC, Alessandrini EA, Browning WL, Myers AL, Neuman MI, Collaborative F. Association of clinical practice guidelines with emergency department management of febrile infants ≤56 days of age. Journal Of Hospital Medicine 2015, 10: 358-365. PMID: 25684689, PMCID: PMC4456211, DOI: 10.1002/jhm.2329.Peer-Reviewed Original ResearchMeSH KeywordsAnti-Bacterial AgentsBlood Chemical AnalysisCeftriaxoneCerebrospinal FluidCost ControlCross-Sectional StudiesEmergency Service, HospitalFeverGuideline AdherenceHealth Care SurveysHealth Information SystemsHospitals, PediatricHumansInfantInfant, NewbornPractice Guidelines as TopicRetrospective StudiesUnited StatesUrinalysisConceptsClinical practice guidelinesCeftriaxone useCPG recommendationsInfants 29CSF testingHealthcare costsED dischargeFebrile infantsPractice guidelinesInstitutional clinical practice guidelinePediatric Health Information SystemRetrospective cross-sectional studyCerebrospinal fluid testingEmergency department managementCross-sectional studyLower healthcare costsRate of urineDiagnosis of feverDays of ageED visitsPractice variationDepartment managementAge groupsHealth information systemsFluid testing
2014
Variation in Care of the Febrile Young Infant <90 Days in US Pediatric Emergency Departments
Aronson PL, Thurm C, Alpern ER, Alessandrini EA, Williams DJ, Shah SS, Nigrovic LE, McCulloh RJ, Schondelmeyer A, Tieder JS, Neuman MI. Variation in Care of the Febrile Young Infant <90 Days in US Pediatric Emergency Departments. Pediatrics 2014, 134: 667-677. PMID: 25266437, DOI: 10.1542/peds.2014-1382.Peer-Reviewed Original ResearchConceptsFebrile young infantsPediatric emergency departmentUS pediatric emergency departmentsHospital-level variationEmergency departmentHospitalization ratesInterhospital variationYoung infantsAge groupsSignificant interhospital variationRetrospective cohort studyCerebrospinal fluid testingProportion of patientsQuality of careDays of ageInfants 29Substantial patientCohort studyED visitsOverall cohortPatient ageED managementDiagnosis codesInclusion criteriaModifiable source