Observational studyArchives of disease in childhood2020
Association between hypotension and serious illness in the emergency department: an observational study.
Observational study in Archives of disease in childhood, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A comparison of clinical paediatric guidelines for hypotension with population-based lower centiles: a systematic review.Critical care (London, England) · 2019Pooled it
- Management of arterial hypotension in critically Ill children: a narrative review and practical approach.Frontiers in pediatrics · 2026Review
- The Epidemiology of Emergency Calls in a Tertiary Emergency Department for Admitted Patients: A TECOR Study.Healthcare (Basel, Switzerland) · 2025Article
- Article
- Ranking Nursing Diagnoses by Predictive Relevance for Intensive Care Unit Transfer Risk in Adult and Pediatric Patients: A Machine Learning Approach with Random Forest.Healthcare (Basel, Switzerland) · 2025Article
- Article
- The Resuscitation, Equilibrium and De-escalation (RED) strategy: a phased, personalized hemodynamic support in children with sepsis.Frontiers in pediatrics · 2025Review
- Physicians' Knowledge of the Systematic ABCDE Approach in Riyadh, Saudi Arabia.Journal of multidisciplinary healthcare · 2024Article
- Shock Index in the early assessment of febrile children at the emergency department: a prospective multicentre study.Archives of disease in childhood · 2022Observational
- Characteristics and management of adolescents attending the ED with fever: a prospective multicentre study.BMJ open · 2022Article
- A NICE combination for predicting hospitalisation at the Emergency Department: a European multicentre observational study of febrile children.The Lancet regional health. Europe · 2021Article
- Article
- Delayed haemolysis following artesunate in a child with profound anaemia and Coca-Cola-coloured urine.BMJ case reports · 2020Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe value of routine blood pressure measurement in the emergency department (ED) is unclear.
objectiveTo determine the association between hypotension in addition to tachycardia and the Shock Index for serious illness.
designObservational study.
settingUniversity ED (2009-2016). PARTICIPANTS, METHODS AND MAIN OUTCOMES: Routine data collected from consecutive children <16 years. Using logistic regression, we assessed the association between hypotension (adjusted for tachycardia) and Shock Index (ratio heart rate/blood pressure [BP]) for serious illness. The predictive accuracy (sensitivity, specificity) for hypotension and Shock Index was determined for serious illness, defined as intensive care unit (ICU) and hospital admissions.
resultsWe included 10 698 children with measured BP. According to three age-adjusted clinical cut-offs (Advanced Paediatric Life Support, Paediatric Advanced Life Support and Paediatric Early Warning Score), hypotension was significantly associated with ICU admission when adjusted for tachycardia (range OR 2.6-5.3). Hypotension showed low sensitivity (range 0.05-0.12) and high specificity (range 0.95-0.99) for ICU admission. Combining hypotension and tachycardia did not change the predictive value for ICU admission. Similar results were found for hospitalisation. Shock index was associated with serious illness. However, no specific cut-off value was identified in different age groups.
conclusionsHypotension, adjusted for tachycardia, is associated with serious illness, although its sensitivity is limited. Shock index showed an association with serious illness, but no acceptable cut-off value could be identified. Routine BP measurement in all children to detect hypotension has limited value in the ED. Future studies need to confirm which patients could benefit from BP measurement.
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