title: The usefulness of clinical and laboratory parameters for predicting severity of dehydration in children with acute gastroenteritis.
abstract: BACKGROUND
  An accurate assessment of the degree of dehydration in infants and children is important for proper decision-making and treatment. This emphasizes the need for laboratory tests to improve the accuracy of clinical assessment of dehydration. The aim of this study was to assess the relationship between clinical and laboratory parameters in the assessment of dehydration.
  
  
  METHODS
  We evaluated prospectively 200 children aged 1 month to 5 years who presented with diarrhea, vomiting or both. Dehydration assessment was done following a known clinical scheme.
  
  
  RESULTS
  We enrolled in the study 200 children (57.5% were male). The mean age was 15.62±9.03 months, with more than half those studied being under 24 months old. Overall, 46.5% (93) had mild dehydration, 34% (68) had moderate dehydration, 5.5% (11) had severe dehydration whereas, 14% (28) had no dehydration. Patients historical clinical variables in all dehydration groups did not differ significantly regarding age, sex, fever, frequency of vomiting, duration of diarrhea and vomiting, while there was a trend toward severe dehydration in children with more frequent diarrhea (p=0.004). Serum urea and creatinine cannot discriminate between mild and moderate dehydration but they showed a good specificity for severe dehydration of 99% and 100% respectively. Serum bicarbonates and base excess decreased significantly with a degree of dehydration and can discriminate between all dehydration groups (P<0.001).
  
  
  CONCLUSIONS
  Blood gases were useful to diagnose the degree of dehydration status among children presenting with acute gastroenteritis. Serum urea and creatinine were the most specific tests for severe dehydration diagnosis. Historical clinical patterns apart from frequency of diarrhea did not correlate with dehydration status. Further studies are needed to validate our results.
authors.affiliation: Pediatric Clinic, University Clinical Center of Kosova, Prishtina, Kosovo ; Department of Statistics, Faculty of Medicine, University of Tirana, Tirana, Albania.
authors.forename: Teuta Faik
authors.initials: TF
authors.lastname: Hoxha
authors.affiliation: Pediatric Clinic, University Clinical Center of Kosova, Prishtina, Kosovo ; Department of Statistics, Faculty of Medicine, University of Tirana, Tirana, Albania.
authors.forename: Mehmedali
authors.initials: M
authors.lastname: Azemi
authors.affiliation: Pediatric Clinic, University Clinical Center of Kosova, Prishtina, Kosovo ; Department of Statistics, Faculty of Medicine, University of Tirana, Tirana, Albania.
authors.forename: Muharrem
authors.initials: M
authors.lastname: Avdiu
authors.affiliation: Pediatric Clinic, University Clinical Center of Kosova, Prishtina, Kosovo ; Department of Statistics, Faculty of Medicine, University of Tirana, Tirana, Albania.
authors.forename: Vlora
authors.initials: V
authors.lastname: Ismaili-Jaha
authors.affiliation: Pediatric Clinic, University Clinical Center of Kosova, Prishtina, Kosovo ; Department of Statistics, Faculty of Medicine, University of Tirana, Tirana, Albania.
authors.forename: Violeta
authors.initials: V
authors.lastname: Grajqevci
authors.affiliation: Pediatric Clinic, University Clinical Center of Kosova, Prishtina, Kosovo ; Department of Statistics, Faculty of Medicine, University of Tirana, Tirana, Albania.
authors.forename: Ela
authors.initials: E
authors.lastname: Petrela
mesh_terms: D000208:Acute Disease; D001784:Blood Gas Analysis; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood*; D003681:Dehydration / Q000175:diagnosis*; D005260:Female; D005759:Gastroenteritis / Q000150:complications*; D006801:Humans; D007223:Infant; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D014508:Urea / Q000097:blood*
chemical_list: D014508:Urea; D003404:Creatinine
keywords: Acute gastroenteritis; dehydration in children; diarrhea in children