دورية أكاديمية
Risk Perception and Decision Making about Early-Onset Sepsis among Neonatologists: A National Survey.
| العنوان: | Risk Perception and Decision Making about Early-Onset Sepsis among Neonatologists: A National Survey. |
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| المؤلفون: | Rugolo LMSS; Division of Neonatology, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista-UNESP, Botucatu, Brazil., Bentlin MR; Division of Neonatology, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista-UNESP, Botucatu, Brazil., Almeida MFB; Division of Neonatal Medicine, Escola Paulista de Medicina da Universidade Federal de São Paulo, São Paulo, Brazil., Guinsburg R; Division of Neonatal Medicine, Escola Paulista de Medicina da Universidade Federal de São Paulo, São Paulo, Brazil., Carvalho WB; Department of Pediatrics, University of São Paulo, School of Medicine, São Paulo, Brazil., Marba STM; Department of Pediatrics, Faculdade de Ciências Médicas da Universidade Estadual de Campinas, Brazil., Almeida JHCL; Division of Neonatology, Instituto Nacional de Saúde da Criança, Mulher e Adolescente Fernandes Figueira-Fundação Oswaldo Cruz, Rio de Janeiro, Brazil., Luz JH; Department of Pediatrics, Hospital São Lucas-Faculdade de Medicina da Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil., Procianoy RS; Division of Neonatology, Universidade Federal do Rio Grande do Sul/Hospital de Clínicas de Porto Alegre -HCPA, Porto Alegre, Brazil., Duarte JLMB; Department of Pediatrics, Hospital Universitário Pedro Ernesto-Universidade do Estado de Rio de Janeiro, Rio de Janeiro, Brazil., Anchieta LM; Division of Neonatology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., Ferreira DMLM; Department of Pediatrics, Universidade Federal de Uberlândia, Uberlândia, Brazil., Alves Júnior JMS; Department of Pediatrics, Maternidade Hilda Brandão-Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil., Diniz EMA; Division of Neonatology, University of São Paulo, Brazil da Universidade de São Paulo, Hospital Universitário, São Paulo, Brazil., Santos JPFD; Division of Neonatal, Hospital Estadual Sumaré, Sumaré, Brazil., Gimenes CB; Neonatal Unit, Hospital Geral de Pirajussara, Taboão da Serra, Brazil., Silva NMME; Neonatal Unit, Hospital Estadual de Diadema, Diadema, Brazil., Ferrari LL; Department of Pediatrics, Hospital Universitário-Universidade Estadual de Londrina, Londrina, Brazil., Silva RPGVCD; Department of Pediatrics, Hospital de Clínicas-Universidade Federal do Paraná, Curitiba, Brazil., Meneses J; Department of Pediatrics, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil., Gonçalves-Ferri WA; Department of Pediatrics, Faculdade de Medicina de Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil., Vale MSD; Department of Pediatrics, Universidade Federal do Maranhão, São Luís, Brazil., Brine H; Departent of Pediatrics, Promedica Toledo Children's Hospital, University of Toledo, Ohio., Weiner GM; Department of Pediatrics, Neonatal-Perinatal Medicine, University of Michigan, Ann Arbor, Michigan. |
| مؤلفون مشاركون: | Brazilian Network on Neonatal Research |
| المصدر: | American journal of perinatology [Am J Perinatol] 2022 Jul; Vol. 39 (10), pp. 1117-1123. Date of Electronic Publication: 2020 Dec 20. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Thieme-Stratton Country of Publication: United States NLM ID: 8405212 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1098-8785 (Electronic) Linking ISSN: 07351631 NLM ISO Abbreviation: Am J Perinatol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York, NY : Thieme-Stratton, 1983- |
| مواضيع طبية MeSH: | Neonatal Sepsis*/diagnosis , Neonatal Sepsis*/drug therapy , Sepsis*/diagnosis , Sepsis*/drug therapy, Anti-Bacterial Agents/therapeutic use ; Decision Making ; Humans ; Infant ; Infant, Newborn ; Neonatologists ; Perception ; Retrospective Studies ; Risk Factors |
| مستخلص: | Objective: Many newborns are investigated and empirically treated for suspected early-onset sepsis (EOS). This study aimed to describe neonatologists' self-identified risk thresholds for investigating and treating EOS and assess the consistency of these thresholds with clinical decisions. Study Design: Voluntary online survey, available in two randomized versions, sent to neonatologists from 20 centers of the Brazilian Network on Neonatal Research. The surveys included questions about thresholds for investigating and treating EOS and presented four clinical scenarios with varying calculated risks. In survey version A, only the scenarios were presented, and participants were asked if they would order a blood test or start antibiotics. Survey version B presented the same scenarios and the risk of sepsis. Clinical decisions were compared between survey versions using chi-square tests and agreement between thresholds and clinical decisions were investigated using Kappa coefficients. Results: In total, 293 surveys were completed (145 survey version A and 148 survey version B). The median risk thresholds for blood test and antibiotic treatment were 1:100 and 1:25, respectively. In the high-risk scenario, there was no difference in the proportion choosing antibiotic therapy between the groups. In the moderate-risk scenarios, both tests and antibiotics were chosen more frequently when the calculated risks were included (survey version B). In the low-risk scenario, there was no difference between survey versions. There was poor agreement between the self-described thresholds and clinical decisions. Conclusion: Neonatologists overestimate the risk of EOS and underestimate their risk thresholds. Knowledge of calculated risk may increase laboratory investigation and antibiotic use in infants at moderate risk for EOS. Key Points: · Neonatologists overestimate the risk of EOS.. · There is wide variation in diagnostic/treatment thresholds for EOS.. · Clinical decision on EOS is not consistent with risk thresholds.. · Knowledge of risk may increase investigation and treatment of EOS.. Competing Interests: None declared. (Thieme. All rights reserved.) |
| المشرفين على المادة: | 0 (Anti-Bacterial Agents) |
| تواريخ الأحداث: | Date Created: 20201220 Date Completed: 20220728 Latest Revision: 20220812 |
| رمز التحديث: | 20240829 |
| DOI: | 10.1055/s-0040-1721691 |
| PMID: | 33341925 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1098-8785 |
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| DOI: | 10.1055/s-0040-1721691 |