Diagnostic accuracy of tachypnoea for predicting mortality and identifying sepsis in young infants aged 0–59 days: a systematic review and meta-analysis - Summary - MDSpire
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Evaluating the Diagnostic Precision of Tachypnoea in Forecasting Mortality and Detecting Sepsis in Infants Aged 0–59 Days: A Systematic Review and Meta-Analysis
To systematically review evidence on the diagnostic accuracy of different tachypnoea thresholds for predicting mortality and sepsis in infants aged 0–59 days.
Approach:
Study Selection: Searched MEDLINE, Embase, CINAHL, Global Index Medicus, and CENTRAL for studies reporting associations or diagnostic accuracy of tachypnoea (≥60, ≥70 or ≥80 bpm) for predicting mortality and culture-confirmed sepsis.
Data Analysis: Pooled ORs using random-effects models and sensitivity/specificity using random-effects bivariate models; assessed certainty of evidence using GRADE.
Key Findings:
Tachypnoea≥60 bpm had a pooled OR of 3.14 (95% CI 1.30 to 7.56; 5 studies; n=10,407) for predicting mortality.
Sensitivity of tachypnoea≥60 bpm for mortality was 31% (95% CI 19% to 45%) and specificity was 89% (95% CI 66% to 97%; 4 studies; n=7104).
For culture-confirmed sepsis, tachypnoea≥60 bpm had an OR of 1.26 (95% CI 0.66 to 2.38; 4 studies; n=3996), sensitivity of 28% (95% CI 10% to 58%), and specificity of 67% (95% CI 53% to 78%; 3 studies; n=693).
Tachypnoea≥70 bpm was associated with an OR of 10.06 (95% CI 2.39 to 42.35; 2 studies; n=12,138) for mortality but had lower sensitivity (10.9% (95% CI 5.3% to 19.1%)).
Interpretation:
Tachypnoea≥60 bpm is associated with increased odds of mortality in young infants, but its low sensitivity suggests it should be used alongside other clinical signs.
Limitations:
Data were insufficient to assess performance by age subgroup (0–6 vs 7–59 days).
The certainty of evidence was very low.
Conclusion:
Tachypnoea remains an important sign for predicting mortality and identifying sepsis in young infants, but should not be used in isolation.
by Suci Ardini Widyaningsih, Sophie Driker, Alastair Fung, Naomi Schmeck, Sitarah Mathias, Megan Yu, Yasir Shafiq, Amber Hoey, Tessa Kehoe, Yumin Kim, Jana Adnan, Anum S Hussaini, Carrie G Wade, Anne CC Lee
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