Chong et al reported the Febrile Infants Risk Score at Triage (FIRST) for identifying an infant with a serious bacterial infection. The authors are from multiple institutions in Singapore and Duke-NUS Medical School.
Patient selection: febrile infant < 3 months old
Parameters:
(1) age in days
(2) temperature in °C
(3) sex
(4) days with fever
Parameter
Finding
Points
age in days
< 21 days
17
21 to 27.99 days
0
>= 28 days
30
temperature
< 38.5°C
0
38.5 to 38.9°C
4
39.0 to 39.9°C
13
>= 40°C
43
sex
female
0
male
17
day of fever
< 2 days
0
>= 2 days
9
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 99
• The higher the score the greater the risk of a serious bacterial infection (SBI).
• A score >= 30 is associated with a 15% risk of SBI.
Performance:
• The area under the ROC curve is 0.74 for the derivation and 0.71 for the validation cohorts.
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