Triage Performance and Physiological Predictors of Serious Illness in Febrile Children in the Pediatric Emergency Department

This multicenter prospective observational cohort study evaluates how well the initial triage category assigned by the Turkish Ministry of Health three-level color-coded triage system (Red-Yellow-Green) predicts serious clinical outcomes in children aged 0-18 years who present with fever to pediatric emergency departments. The study additionally assesses whether physiological parameters recorded at triage (heart rate, respiratory rate, oxygen saturation, capillary refill time, AVPU level of consciousness, and general appearance) provide independent and incremental prognostic value beyond the assigned triage category. Ten centers across Turkey will enroll consecutive eligible febrile children over a 3-month period. Routine clinical care and triage decisions are not altered by the study. The primary outcome is a composite serious clinical outcome. The study is reported in accordance with the STROBE and TRIPOD statements.

Inclusion Criteria: * Age 0-18 years * Presentation to the pediatric emergency department * Fever \>=38.0 C at triage OR history of fever within the preceding 24 hours Exclusion Criteria: * Presentation due to trauma * Elective visits * Missing triage data * Re-attendance within 72 hours for the same episode (only the first visit is included)