Prediction of severe disease in children with diarrhea in a resource-limited setting

PloS One
Adam C LevinePeter C Drobac

Abstract

To investigate the accuracy of three clinical scales for predicting severe disease (severe dehydration or death) in children with diarrhea in a resource-limited setting. Participants included 178 children admitted to three Rwandan hospitals with diarrhea. A local physician or nurse assessed each child on arrival using the World Health Organization (WHO) severe dehydration scale and the Centers for Disease Control (CDC) scale. Children were weighed on arrival and daily until they achieved a stable weight, with a 10% increase between admission weight and stable weight considered severe dehydration. The Clinical Dehydration Scale was then constructed post-hoc using the data collected for the other two scales. Receiver Operator Characteristic (ROC) curves were constructed for each scale compared to the composite outcome of severe dehydration or death. The WHO severe dehydration scale, CDC scale, and Clinical Dehydration Scale had areas under the ROC curves (AUCs) of 0.72 (95% CI 0.60, 0.85), 0.73 (95% CI 0.62, 0.84), and 0.80 (95% CI 0.71, 0.89), respectively, in the full cohort. Only the Clinical Dehydration Scale was a significant predictor of severe disease when used in infants, with an AUC of 0.77 (95% CI 0.61, 0.93), and when ...Continue Reading

References

Jan 1, 1991·Journal of Clinical Epidemiology·D L SimelD B Matchar
Jan 1, 1996·Journal of Pediatric Gastroenterology and Nutrition·C DugganM Santosham
Jan 1, 2003·Clinical Chemistry·Patrick M BossuytUNKNOWN Standards for Reporting of Diagnostic Accuracy
Jan 7, 2003·Annals of Internal Medicine·Patrick M BossuytUNKNOWN Standards for Reporting of Diagnostic Accuracy
Nov 25, 2003·MMWR. Recommendations and Reports : Morbidity and Mortality Weekly Report. Recommendations and Reports·Caleb K KingUNKNOWN Centers for Disease Control and Prevention
May 5, 2004·Archives of Pediatrics & Adolescent Medicine·Bob K FonsecaJonathan C Craig
Jun 10, 2004·JAMA : the Journal of the American Medical Association·Michael J SteinerJulie S Byerley
Aug 4, 2004·The Journal of Pediatrics·Jeremy N FriedmanPatricia C Parkin
Jan 29, 2005·JAAPA : Official Journal of the American Academy of Physician Assistants·Molly Ulrickson
Sep 28, 2005·Indian Journal of Pediatrics·Nidhi ChaudharyMinakshi Sharma
Apr 7, 2009·The Journal of Emergency Medicine·James E CollettiUNKNOWN ACEP Pediatric Emergency Medicine Committee
Jun 3, 2009·Clinical Pediatrics·Patricia C ParkinJeremy N Friedman
Jul 14, 2010·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Benoit BaileyPatricia C Parkin
Nov 3, 2010·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Adam C LevineVicki E Noble
Sep 10, 2011·International Journal of Emergency Medicine·Kimberly PringleAdam C Levine
Apr 25, 2012·Pediatrics·Laura M Kinlin, Stephen B Freedman
Sep 18, 2012·The Journal of Nutritional Biochemistry·Huanbiao MoChwan-Li Shen
Dec 26, 2012·La Presse médicale·Thanh Van Trieu, Loïc De Pontual
Apr 16, 2013·Lancet·Christa L Fischer WalkerRobert E Black

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