Point-of-care C reactive protein to identify serious infection in acutely ill children presenting to hospital : prospective cohort study

Objective: Acute infection is the most common presentation of children to hospital. A minority of these infections are serious, but early recognition and adequate management are essential. We aimed to develop improved tools to assess children attending ambulatory hospital care, integrating clinical features with point-of-care C reactive protein (CRP). Design: Prospective observational diagnostic study. Setting and patients: 5517 acutely ill children (1 month-16 years) presenting to 106 paediatricians at six outpatient clinics and six emergency departments in Belgium. Index test: Point-of-care CRP alongside vital signs and objective symptoms measurements. Main outcome: Hospital admission for >24 hours with a serious infection 75 mg/L (26.8% risk of infection), intermediate-risk group with CRP 20-75 mg/L and at least one of seven clinical features (8.1%), and lower risk group with CRP 24 hours with a serious infection 75 mg/L (26.8% risk of infection), intermediate-risk group with CRP 20-75 mg/L and at least one of seven clinical features (8.1%), and lower risk group with CRP