Evidence map›Paper›PMID 23122417›Full record

ArticleInfluenza and other respiratory viruses2013

Comparing the use of, and considering the need for, lumbar puncture in children with influenza or other respiratory virus infections.

Gulam Khandaker, Leon Heron, Harunor Rashid, Jean Li-Kim-Moy, David Lester-Smith, Alison Kesson, Mary McCaskill, Cheryl Jones, Yvonne Zurynski, Elizabeth J Elliott and 2 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Influenza and other respiratory viruses, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 6 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 2 institutions in 1 country.

Gulam KhandakerNational Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children's Hospital at Westmead and The University of SydneyThe Children's Hospital at Westmead and The University of SydneyThe Sydney Institute for Emerging Infections and Biosecurity (SEIB), Sydney Medical School, The University of SydneyDiscipline of Paediatrics and Child Health, Sydney Medical School, The University of SydneyThe Australian Paediatric Surveillance UnitCentre for Infectious Diseases and Microbiology Laboratory Services (CIDMLS), Institute for Clinical Pathology and Medical Research (ICPMR), Westmead Hospital and The University of Sydney, Sydney, NSW, Australia.
Leon Heron
Harunor Rashid
Jean Li-Kim-Moy
David Lester-Smith
Alison Kesson
Mary McCaskill
Cheryl Jones
Yvonne Zurynski
Elizabeth J Elliott
Dominic E Dwyer
Robert Booy
The University of Sydney · AUChildren's Hospital at Westmead · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe clinical presentation of influenza in infancy may be similar to serious bacterial infection and be investigated with invasive procedures like lumbar puncture (LP), despite very limited evidence that influenza occurs concomitantly with bacterial meningitis, perhaps because the diagnosis of influenza is very often not established when the decision to perform LP is being considered.

methodsA retrospective medical record review was undertaken in all children presenting to the Children's Hospital at Westmead, Sydney, Australia, in one winter season with laboratory-confirmed influenza or other respiratory virus infections (ORVIs) but excluding respiratory syncytial virus, to compare the use of, and reflect on the need for, the performance of invasive diagnostic procedures, principally LP, but also blood culture, in influenza and non-influenza cases. We also determined the rate of concomitant bacterial meningitis or bacteraemia.

findingsOf 294 children, 51% had laboratory-confirmed influenza and 49% had ORVIs such as parainfluenza viruses (34%) and adenoviruses (15%). Of those with influenza, 18% had a LP and 71% had a blood culture performed compared with 6·3% and 55·5% in the ORVI group (for both P<0·01). In multivariate analysis, diagnosis of influenza was a strong independent predictor of both LP (P=0·02) and blood culture (P=0·05) being performed, and, in comparison with ORVIs, influenza cases were almost three times more likely to have a LP performed on presentation to hospital. One child with influenza (0·9%) had bacteraemia and none had meningitis.

interpretationChildren with influenza were more likely to undergo LP on presentation to hospital compared with those presenting with ORVIs. If influenza is confirmed on admission by near-patient testing, clinicians may be reassured and less inclined to perform LP, although if meningitis is clinically suspected, the clinician should act accordingly. We found that the risk of bacterial meningitis and bacteraemia was very low in hospitalised children with influenza and ORVIs. A systematic review should be performed to investigate this across a large number of settings.

Indexed as

AdolescentAustraliaBacteremiaChildChild, PreschoolDiagnosis, DifferentialFemaleHumansInfantInfant, NewbornMaleMeningitis, BacterialRespiratory Tract InfectionsRetrospective StudiesSpinal PunctureVirus DiseasesBacterial meningitischildreninfluenzalumbar puncturerespiratory viral infection

Identifiers

PMID23122417
PMCPMC4634251
OpenAlexW1480727938

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.