ArticleThe western journal of emergency medicine2020
United States' Emergency Department Visits for Fever by Young Children 2007-2017.
Article in The western journal of emergency medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 25 citations in OpenAlex.
- Impact of implementing a clinical decision rule on the use of empirical antibiotics and invasive procedures.BMJ paediatrics open · 2026Article
- Variation in management of febrile infants younger than 90 days across London: a retrospective cohort study.European journal of pediatrics · 2026Article
- Prediction Rule to Identify Febrile Infants 61-90 Days at Low Risk for Invasive Bacterial Infections.Pediatrics · 2025Article
- Risk of Bacterial Infections in Febrile Infants 61 to 90 Days Old With Respiratory Viruses.Pediatrics · 2025Article
- Urine Testing in Children with Viral Symptoms: A Nationwide Analysis of Ambulatory Visits, 2014-2019.The Journal of pediatrics · 2025Article
- Natural Language Processing to Identify Infants Aged 90 Days and Younger With Fevers Prior to Presentation.Hospital pediatrics · 2025Article
- Performance of AAP CPG for Ineligible Well-Appearing Febrile Infants Aged 8-60 Days.Hospital pediatrics · 2024Article
- Optimizing Diagnosis and Management of Community-acquired Pneumonia in the Emergency Department.Emergency medicine clinics of North America · 2024Review
- The Diagnostic Value of Human Neutrophilic Peptides 1-3 in Acute Pediatric Febrile Illness.Journal of clinical medicine · 2023Article
- Prevalence of Urinary Tract Infection, Bacteremia, and Meningitis Among Febrile Infants Aged 8 to 60 Days With SARS-CoV-2.JAMA network open · 2023Article
- Pyrexia in a young infant - is height of fever associated with serious bacterial infection?BMC pediatrics · 2022Article
- Fever in Children Under 5 years: Caregivers' Knowledge and Home Management Practices in the Northern Region of Ghana - A Multi-Facility Study.Sage open pediatricsArticle
- Impact of a Hypothermic Young Infant Clinical Pathway: A Single Site Study.Sage open pediatricsArticle
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
introductionOur goal in this study was to estimate rates of emergency department (ED) visits for fever by children <2 years of age, and evaluate frequencies of testing and treatment during these visits.
methodsWe performed a cross-sectional study of ED encounters from 2007-2017 using the National Hospital Ambulatory Medical Care Survey, a cross-sectional, multi-stage probability sample survey of visits to nonfederal United States EDs. We included encounters with a visit reason of "fever" or recorded fever in the ED. We report demographics and management strategies in two groups: infants ≤90 days in age; and children 91 days to <2 years old. For patients 91 days to <2 years, we compared testing and treatment strategies between general and pediatric EDs using chi-squared tests.
resultsOf 1.5 billion encounters over 11 years, 2.1% (95% confidence interval [CI], 1.9-2.2%) were by children <2 years old with fever. Two million encounters (95% CI, 1.7-2.4 million) were by infants ≤90 days, and 28.4 million (95% CI, 25.5-31.4 million) were by children 91 days to <2 years. Among infants ≤90 days, 27.6% (95% CI, 21.1-34.1%) had blood and 21.3% (95% CI, 13.6-29.1%) had urine cultures; 26.8% (95% CI, 20.9-32.7%) were given antibiotics, and 21.1% (95% CI, 15.3-26.9%) were admitted or transferred. Among patients 91 days to <2 years in age, 6.8% (95% CI, 5.8-7.8%) had blood and 7.7% (95% CI 6.1-9.4%) had urine cultures; 40.5% (95% CI, 40.5-40.5%) were given antibiotics, and 4.4% (95% CI, 3.5-5.3%) were admitted or transferred. Patients 91 days to <2 years who were evaluated in general EDs had higher rates of radiography (27.1% vs 15.2%; P<0.01) and antibiotic utilization (42.3% vs 34.2%; P<0.01), but lower rates of urine culture testing (6.4% vs 11.6%, p = 0.03), compared with patients evaluated in pediatric EDs.
conclusionApproximately 180,000 patients ≤90 days old and 2.6 million patients 91 days to <2 years in age with fever present to US EDs annually. Given existing guidelines, blood and urine culture performance was low for infants ≤90 days old. For children 91 days to <2 years, rates of radiography and antibiotic use were higher in general EDs compared to pediatric EDs. These findings suggest opportunities to improve care among febrile young children in the ED.
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