{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T09:57:59Z","timestamp":1777024679111,"version":"3.51.4"},"reference-count":26,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,7,1]]},"abstract":"<jats:sec><jats:title>OBJECTIVES:<\/jats:title><jats:p>To assess the performance of the Yale Observation Scale (YOS) score and unstructured clinician suspicion to identify febrile infants \u226460 days of age with and without serious bacterial infections (SBIs).<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>We performed a planned secondary analysis of a prospective cohort of non\u2013critically ill, febrile, full-term infants \u226460 days of age presenting to 1 of 26 participating emergency departments in the Pediatric Emergency Care Applied Research Network. We defined SBIs as urinary tract infections, bacteremia, or bacterial meningitis, with the latter 2 considered invasive bacterial infections. Emergency department clinicians applied the YOS (range: 6\u201330; normal score: \u226410) and estimated the risk of SBI using unstructured clinician suspicion (&amp;lt;1%, 1%\u20135%, 6%\u201310%, 11%\u201350%, or &amp;gt;50%).<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>Of the 4591 eligible infants, 444 (9.7%) had SBIs and 97 (2.1%) had invasive bacterial infections. Of the 4058 infants with YOS scores of \u226410, 388 (9.6%) had SBIs (sensitivity: 51\/439 [11.6%]; 95% confidence interval [CI]: 8.8%\u201315.0%; negative predictive value: 3670\/4058 [90.4%]; 95% CI: 89.5%\u201391.3%) and 72 (1.8%) had invasive bacterial infections (sensitivity 23\/95 [24.2%], 95% CI: 16.0%\u201334.1%; negative predictive value: 3983\/4055 [98.2%], 95% CI: 97.8%\u201398.6%). Of the infants with clinician suspicion of &amp;lt;1%, 106 had SBIs (6.4%) and 16 (1.0%) had invasive bacterial infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>In this large prospective cohort of febrile infants \u226460 days of age, neither the YOS score nor unstructured clinician suspicion reliably identified those with invasive bacterial infections. More accurate clinical and laboratory predictors are needed to risk stratify febrile infants.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2017-0695","type":"journal-article","created":{"date-parts":[[2017,6,6]],"date-time":"2017-06-06T09:10:13Z","timestamp":1496740213000},"source":"Crossref","is-referenced-by-count":72,"title":["The Yale Observation Scale Score and the Risk of Serious Bacterial Infections in Febrile Infants"],"prefix":"10.1542","volume":"140","author":[{"given":"Lise E.","family":"Nigrovic","sequence":"first","affiliation":[{"name":"Division of Emergency Medicine, Boston Children\u2019s Hospital, Boston, Massachusetts;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prashant V.","family":"Mahajan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Hospital of Michigan, Detroit, Michigan;"},{"name":"Departments of Emergency Medicine, and"},{"name":"Pediatrics, University of Michigan, Ann Arbor, Michigan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen M.","family":"Blumberg","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Jacobi Medical Center, Albert Einstein College of Medicine, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorin R.","family":"Browne","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics, and"},{"name":"Emergency Medicine, Children\u2019s Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James G.","family":"Linakis","sequence":"additional","affiliation":[{"name":"Departments of Emergency Medicine, and"},{"name":"Pediatrics, Hasbro Children\u2019s Hospital and Brown University, Providence, Rhode Island;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard M.","family":"Ruddy","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Department of Pediatrics, Cincinnati Children\u2019s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan E.","family":"Bennett","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine, Alfred I. duPont Hospital for Children, Nemours Children\u2019s Health System, Wilmington, Delaware;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander J.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Departments of Emergency Medicine, and"},{"name":"Pediatrics, University of Michigan, Ann Arbor, Michigan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leah","family":"Tzimenatos","sequence":"additional","affiliation":[{"name":"Departments of Emergency Medicine, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth C.","family":"Powell","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Department of Pediatrics, Lurie Children\u2019s Hospital of Chicago, Chicago, Illinois;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth R.","family":"Alpern","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Department of Pediatrics, Lurie Children\u2019s Hospital of Chicago, Chicago, Illinois;"},{"name":"Division of Emergency Medicine, Department of Pediatrics, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T. Charles","family":"Casper","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Care Applied Research Network Data Coordinating Center, Salt Lake City, Utah; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Octavio","family":"Ramilo","sequence":"additional","affiliation":[{"name":"Nationwide Children\u2019s Hospital, Columbus, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan","family":"Kuppermann","sequence":"additional","affiliation":[{"name":"Departments of Emergency Medicine, and"},{"name":"Pediatrics, School of Medicine, University of California, Davis, Sacramento, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the Febrile Infant Working Group of the Pediatric Emergency Care Applied Research Network 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