Study of the Trends in Evaluation and Management of the Young Febrile Infant and its Related Healthcare Costs and Morbidities

 描述（由申请人提供）：在社区和医院急诊科的医生实践中，经常会遇到小于90天的婴儿发烧（通常定义为>38°C）。在美国，每年大约有20万名这样的婴儿，其中5-14%将有严重的和可能危及生命的感染。由于这些婴儿通常没有明显的感染迹象，因此实验室检查通常非常广泛，包括腰椎穿刺评估和培养，血培养，尿分析和培养研究（称为“排除败血症检查”），通常随后进行经验性抗菌治疗和住院密切监测。定义这种方法的现有指南已有20年以上的历史，并基于20-30年的数据。考虑到各种干预措施降低了新生儿严重细菌感染的发生率，以及快速检测诊断不太严重但在这个年龄组非常常见的病毒感染的可用性，临床医生在2014年对这些婴儿的管理中很可能过于保守。美国儿科学会认识到这一现实，并正在制定有史以来第一个指南，以帮助临床医生。在这一过程中，发现了一些知识空白，如果有数据，将大大有助于这项任务。我们在这个项目中的目的是从全国代表性的数据集中产生在这方面三个重要领域的独特数据：1）发烧婴儿住院的数量和流行病学特征; 2）这些婴儿在医院接受的程序和治疗可能遭受的伤害和不良事件的程度; 3）

 DESCRIPTION (provided by applicant): An infant <90 days of age with fever (usually defined as >38°C) is very commonly encountered in physician practices in the community and hospital-based emergency departments. Approximately 200,000 such infants are seen in the United States each year; 5-14% of whom will have a serious and potentially life-threatening infection. Because these babies often do not have overt signs of infection, the adjunctive laboratory testing is often quite extensive including a lumber puncture for evaluation and culture, blood culture, and urinalysis and culture studies (known as the "rule out sepsis workup") often followed by empiric antimicrobial therapy and hospitalization for close monitoring. Available guidelines that have defined this approach are >20 years old and based on 20-30 year old data. Given various interventions that have lowered the incidence of serious bacterial infection in neonates, and the availability of rapid tests to diagnose less serious, but exceedingly common viral infections in this age group, it is quite possible that clinicians are being too conservative in their management of these babies in 2014. The American Academy of Pediatrics recognizes this reality and is developing a first-ever guideline to assist clinicians. In their process, several knowledge gaps have been identified that, if data were available, would greatly assist this task. Our Aim in this project is to generate unique data, from nationally representative datasets, in three areas of importance in this regard: 1) the number of and the epidemiologic characteristics of hospitalizations for infants with fever; 2) the extent of harm and adverse events these babies may sustain from procedures and treatments received while in the hospital; and 3) the economic impact of the