TY  - JOUR
T1  - CLinical decision rule to identify febrile young girls at risk for urinary tract infection
AU  - Gorelick MH, Shaw KN
Y1  - 2000/04/01
N1  - 10.1001/archpedi.154.4.386
JO  - Archives of Pediatrics & Adolescent Medicine
SP  - 386
EP  - 390
VL  - 154
IS  - 4
N2  - Objective 
    To develop a clinical prediction rule to identify febrile young girls needing urine culture for evaluation of urinary tract infection (UTI).Design 
    Prospective cohort study.Setting 
    Urban children's hospital emergency department.Patients 
    All girls younger than 2 years (N=1469) presenting to the emergency department with fever (temperature ≥38.3°C) and without an unequivocal source of fever during a 12-month period.Main Outcome Measures 
    The outcome of interest was UTI, defined as a catheterized urine culture with pure growth of 104 colonies/mL or greater. Candidate predictors included demographic, historical, and physical examination variables. Clinical prediction rules were developed using multiple logistic regression after screening variables for univariate association and reliability.Results 
    The presence of 2 or more of the following 5 variables—less than 12 months old, white race, temperature of 39.0°C or higher, fever for 2 days or more, and absence of another source of fever on examination—predicted UTI with a sensitivity of 0.95 (95% confidence interval, 0.85-0.99) and a specificity of 0.31 (95% confidence interval, 0.28-0.34). In the study population, with an overall prevalence of UTI of 4.3%, the positive predictive value of a score of 2 or more was 6.4% and the negative predictive value of a score of less than 2 was 0.8%.Conclusion 
    Using this clinical decision rule, a strategy of obtaining urine cultures from girls younger than 2 years with a score of 2 or more would lead to identification of 95% of children with UTI and elimination of 30% of unnecessary urine cultures.
SN  - 1072-4710
M3  - doi: 10.1001/archpedi.154.4.386
UR  - http://dx.doi.org/10.1001/archpedi.154.4.386
ER  -