{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T15:45:39Z","timestamp":1772120739873,"version":"3.50.1"},"reference-count":22,"publisher":"Baishideng Publishing Group Inc.","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Clin Pediatr"],"abstract":"<jats:p>BACKGROUND<\/jats:p>\n          <jats:p>Fever is a common cause of medical consultation and hospital admission, particularly among children. Recently, the United Kingdom\u2019s National Institute for Health and Care Excellence (NICE) updated its guidelines for assessing fever in children under five years of age. The efficient assessment and management of children with fever are crucial for improving patient outcomes.<\/jats:p>\n          <jats:p>AIM<\/jats:p>\n          <jats:p>To evaluate fever assessment in hospitalized children and to assess its adherence with the NICE Fever in under 5s guideline.<\/jats:p>\n          <jats:p>METHODS<\/jats:p>\n          <jats:p>We conducted a retrospective cohort review of the electronic medical records of children under five years of age at the Department of Pediatrics, Salmaniya Medical Complex, Bahrain, between June and July 2023. Demographic data, vital signs during the first 48 h of admission, route of temperature measurement, and indications for admission were gathered. Fever was defined according to the NICE guideline. The children were divided into five groups according to their age (0-3 months, &gt; 3-6 months, &gt; 6-12 months, &gt; 12-36 months, and &gt; 36-60 months). Patients with and without fever were compared in terms of demography, indication for admission, route of temperature measurement, and other vital signs. Compliance with the NICE Fever in the under 5s guideline was assessed. Full compliance was defined as &gt; 95%, partial compliance as 70%-95%, and minimal compliance as \u2264 69%. Pearson\u2019s \u03c7 2, Student\u2019s t  test, the Mann-Whitney U  test, and Spearman\u2019s correlation coefficient (rs) were used for comparison.<\/jats:p>\n          <jats:p>RESULTS<\/jats:p>\n          <jats:p>Of the 136 patients reviewed, 80 (58.8%) were boys. The median age at admission was 14.2 [interquartile range (IQR): 1.7-44.4] months, with the most common age group being 36-60 months. Thirty-six (26.4%) patients had fever, and 100 (73.6%) were afebrile. The commonest age group for febrile patients (&gt; 12-36 months) was older than the commonest age group for afebrile patients (0-3 months) (P =  0.027). The median weight was 8.3 (IQR: 4.0-13.3) kg. Patients with fever had higher weight than those without fever [10.2 (IQR: 7.3-13.0) vs  7.1 (IQR: 3.8-13.3) kg, respectively] (P  = 0.034). Gastrointestinal disease was the leading indication for hospital admission (n  = 47, 34.6%). Patients with central nervous system diseases and fever of unknown etiology were more likely to be febrile (P  = 0.030 and P  = 0.011, respectively). The mean heart rate was higher in the febrile group than the afebrile group (140 \u00b1 24 vs  126 \u00b1 20 beats per minute, respectively) [P  = 0.001 (confidence interval: 5.8-21.9)] with a positive correlation between body temperature and heart rate, r  = 0.242, n  = 136, P  = 0.004. A higher proportion of febrile patients received paracetamol (n  = 35, 81.3%) compared to the afebrile patients (n  = 8, 18.6%) (P  &lt; 0.001). The axillary route was the most commonly used for temperature measurements (n  = 40\/42, 95.2%), followed by the rectal route (n  = 2\/42, 4.8%). The department demonstrated full compliance with the NICE guideline for five criteria: the type of thermometer used, route and frequency of temperature measurement, frequency of heart rate measurement, and use of antipyretics as needed. Partial compliance was noted for two criteria, the threshold of fever at 38 \u00b0C or more, and the respiratory rate assessment in febrile patients. Minimal compliance or no record was observed for the remaining three criteria; routine assessment of capillary refill, temperature reassessment 1-2 h after each antipyretic intake, and refraining from the use of tepid sponging.<\/jats:p>\n          <jats:p>CONCLUSION<\/jats:p>\n          <jats:p>This study showed that fever assessment in hospitalized children under five years of age was appropriate, but certain areas of adherence to the NICE guideline still need to be improved.<\/jats:p>","DOI":"10.5409\/wjcp.v13.i1.88864","type":"journal-article","created":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T08:58:54Z","timestamp":1709715534000},"source":"Crossref","is-referenced-by-count":3,"title":["Fever assessment in children under five: Are we following the guidelines?"],"prefix":"10.5409","volume":"13","author":[{"given":"Hasan M","family":"Isa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed J","family":"Isa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murtadha A","family":"Alnasheet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmood M","family":"Mansoor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2060","published-online":{"date-parts":[[2024,3,9]]},"reference":[{"key":"B1","unstructured":"Ischimine P.   Assessment of fever in children. BMJ Best Practice 2023. Cited 26 Aug 2023. Availabe from: https:\/\/bestpractice.bmj.com\/topics\/en-gb\/692#"},{"key":"B2","unstructured":"Fever in under 5s: assessment and initial management. London: National Institute for Health and Care Excellence (NICE); 2021-Nov-26"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3390\/children4090081"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2005.088831"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1093\/pch\/5.5.273"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-018-0994-1"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-6757(97)90133-9"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/s11739-020-02556-0"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3390\/biology10121327"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.24953\/turkjped.2021.03.010"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-020-02097-7"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.18203\/issn.2454-2156.IntJSciRep20202642"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.4314\/ejhd.v21i1.10031"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3329\/cmoshmcj.v18i1.42130"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.59566\/IJBS.2009.5369"},{"key":"B16","unstructured":"Ministry of Health.   Health Statistics 2020. 31 May 2022. Cited 11 Dec 2023. Available from: https:\/\/www.moh.gov.bh\/Content\/Files\/Publications\/statistics\/HS2020\/PDF\/CH-03-vital%20stat_2020%20(2).pdf"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2018-001309"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.31729\/jnma.6889"},{"key":"B19","unstructured":"Merrill C, Owens PL.   Reasons for Being Admitted to the Hospital through the Emergency Department for Children and Adolescents, 2004. In: Healthcare Cost and Utilization Project (HCUP) Statistical Briefs [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2006"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1177\/2333794X19831298"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.14238\/pi57.1.2017.47-51"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.4103\/0300-1652.93789"}],"container-title":["World Journal of Clinical Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.wjgnet.com\/2219-2808\/full\/v13\/i1\/88864.htm","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.wjgnet.com\/2219-2808\/full\/v13\/i1\/88864.htm","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T08:59:23Z","timestamp":1709715563000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.wjgnet.com\/2219-2808\/full\/v13\/i1\/88864.htm"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,9]]},"references-count":22,"journal-issue":{"issue":"1"},"alternative-id":["88864"],"URL":"https:\/\/doi.org\/10.5409\/wjcp.v13.i1.88864","relation":{},"ISSN":["2219-2808"],"issn-type":[{"value":"2219-2808","type":"print"}],"subject":[],"published":{"date-parts":[[2024,3,9]]}}}