Rodríguez-González, MoisésAlonso-Ojembarrena, AlmudenaCastellano-Martínez, AnaEstepa-Pedregosa, LorenaBenavente-Fernández, IsabelLubián López, Simon P2023-01-252023-01-252018-05-24http://hdl.handle.net/10668/12510Current guidelines in Spain recommend performing transthoracic echocardiography (TTE) in all children under 2 years of age with a heart murmur. In 2014, the American Paediatric Association published the first appropriate use criteria (AUC) for outpatient paediatric transthoracic echocardiography (TTE) to promote its cost-efficient use. The aim of this article is to analyse the AUC and other clinical factors as predictors of congenital heart disease (CHD) in children less than 2 years of age with a heart murmur, and to develop a safe and efficient referral strategy. Case-control study conducted with children less than 2 years of age, referred from Paediatric Primary Care to Paediatric Cardiology during a 4-year study. A predictive model for CHD was determined using multivariate analysis. A total of 688 patients were included, with 129 (19%) cases of CHD. An age less than 3 months (adjusted odds ratio [ORa] 3.8 [1.5-8.4], p=.030) and fulfilling AUC (ORa 16.3 [9.4-28.3], p To refer children less than 3 months old, fulfilling AUC, without a concurrent infection, or without negative neonatal pulse oximetry screening, is a safe and efficient strategy for the management of heart murmur in children under 2 years of age.esAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/Cardiopatías congénitasCongenital heart diseaseEchocardiographyEcocardiografíaHeart murmurSoplo cardiacoCase-Control StudiesFemaleHeart Defects, CongenitalHeart MurmursHumansInfantInfant, NewbornMaleReferral and ConsultationRetrospective Studiesresearch article29803643open access10.1016/j.anpedi.2018.01.0072341-2879https://doi.org/10.1016/j.anpedi.2018.01.007