Derivation and validation of the Pediatric Community‐Acquired Pneumonia Severity (PedCAPS) score: A prospective cohort study
Year: 2025
Type: article
Abstract: INTRODUCTION: Community-acquired pneumonia (CAP) is a frequent and costly cause of pediatric emergency department (ED) visits and hospitalizations. Previous prognostic tools for CAP are limited by small samples, single-center or retrospective designs, lack of generalizability to ED settings, lack of biomarkers, or limited objective data. To overcome these limitations, we will derive and externally validate a prediction rule for pediatric CAP severity in a large, multicenter prospective cohort. METHODS: This is a prospective cohort study of children 3 months to 18 years old with CAP who present to EDs within the Pediatric Emergency Care Applied Research Network. Enrollment began 8/2023 and will end 7/2027. We exclude children with recent hospitalizations and chronic conditions (e.g., immunosuppression). A follow-up survey and record review is completed 8-15 days after the visit. Blood and nasal specimens are obtained to evaluate the role of C-reactive protein, procalcitonin, proadrenomedullin, and viral detection in severity prediction. The primary outcome is severity (three-tiered outcome of mild, moderate, or severe CAP) within 7 days of ED presentation. Model derivation will occur in ~4000 children from 7 EDs over 2 years. External validation will occur in a distinct cohort of at least 2000 children from 7 different EDs. Penalized regression, recursive partitioning, and machine learning will be used in model development. DISCUSSION: At study completion, we will have a validated CAP severity prediction rule well-positioned for implementation and further evaluation. We will also understand the role of specific biomarkers in predicting outcomes in children with CAP.
Source: Journal of Hospital Medicine
DOI: 10.1002/jhm.70220
Authors: Todd A. Florin, Ron Reeder, Lilliam Ambroggio, Richard M. Ruddy, Samir S. Shah, Allison Cator, Matthew J. Lipshaw, Geoffrey A. Capraro, Laura F. Sartori, Amy Y. Cheng, Leah Tzimenatos, Patrick S. Walsh, Claudia R. Morris, Chris A. Rees, Son H. McLaren, Tamar R. Lubell, Chari D. Larsen, Justin Moher, Eileen J. Klein, Shubhada Hooli, Nathan Kuppermann
Institutions: Northwestern University, Lurie Children's Hospital, University of Utah, Children's Hospital Colorado, University of Colorado Anschutz, Cincinnati Children's Hospital Medical Center, University of Cincinnati, University of Michigan, C. S. Mott Children's Hospital, Brown University, Hasbro Children's Hospital, Children's Hospital of Philadelphia, University of Pennsylvania, The University of Texas Southwestern Medical Center, University of California Davis Medical Center, University of California, Davis, Medical College of Wisconsin, Emory University, Children's Healthcare of Atlanta, Columbia University Irving Medical Center, Columbia University, University of Washington, Baylor College of Medicine, Texas Children's Hospital, Children's National
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,400
Awards: G2482925018, G2810492374
OpenAlex ID: W4416533941