Clinical and laboratory assessment of dehydration severity in children with acute gastroenteritis.
OBJECTIVE
To evaluate clinical and laboratory assessment of dehydration severity in children, 1 to 36 months, with acute gastroenteritis.


METHODS
Clinical and laboratory measures and weight change following rehydration were collected for enrolled children.


METHODS
Pediatric emergency department.


RESULTS
Likelihood ratio (LR+) and 95% confidence interval (CI): for a clinical score of 0, the LR+ was 2.2 (95% CI = 0.9-5.3); for a clinical score of 1 to 4, the LR+ was 1.3 (95% CI = 0.90-1.74); for a clinical score of 5 to 8, the LR+ was 5.2 (95% CI = 2.2-12.8); for a venous pH <7.32, the LR+ was 7.2 (95% CI = 2.4-21.9); and for serum bicarbonate <18 mmol/L, the LR+ was 11.6 (95% CI = 3.5-38.0).


CONCLUSIONS
Clinicians may find it useful to incorporate the Clinical Dehydration Scale and laboratory measures into clinical decision-making algorithms to assess dehydration severity in children with acute gastroenteritis.
Parkin
Patricia C
PC
Division of Pediatric Medicine and the Pediatric Outcomes Research Team, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada. patricia.parkin@sickkids.ca
Macarthur
Colin
C
Khambalia
Amina
A
Goldman
Ran D
RD
Friedman
Jeremy N
JN
D000208:Acute Disease; D001639:Bicarbonates / Q000097:blood*; D001835:Body Weight; D002675:Child, Preschool; D003681:Dehydration / Q000097:blood* / Q000209:etiology / Q000503:physiopathology*; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D005440:Fluid Therapy; D005759:Gastroenteritis / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D014883:Water-Electrolyte Imbalance / Q000097:blood / Q000175:diagnosis* / Q000209:etiology
D001639:Bicarbonates