Although most cases of acute gastroenteritis (AGE) in children recover quickly, some children have more serious and persistent diseases. For a study, researchers sought to create a prognostic score to identify children at risk of developing moderate-to-severe illness following an index ED visit. Data were obtained from a cohort of children diagnosed with AGE in 16 North American pediatric emergency departments aged 3 to 48 months. A Modified Vesikari Scale (MVS) score of 9 on the 14-day post-ED visit was regarded as having moderate-to-severe AGE. Using multivariable logistic regression, a clinical prognostic model was developed and transformed into a simple risk score. The model’s accuracy for moderate-to-severe AGE and various secondary outcomes was evaluated.
Following the initial ED visit, 19% (336/1770) of patients had moderate-to-severe AGE. In multivariable regression, patient age, number of vomiting episodes, dehydration status, past ED visits, and intravenous rehydration were linked with MVS9. The Hosmer-Lemeshow goodness-of-fit test revealed that the prognostic model was well-calibrated, with a P-value of 0.77, and discrimination was modest, with an area under the receiver operator characteristic curve of 0.68 (95% CI 0.65–0.72). Similarly, when fit to the secondary outcomes of future ED visits, intravenous rehydration, or hospitalization within 72 hours after the index visit, the model was demonstrated to have satisfactory calibration.
The novel risk score, after external validation, might give doctors a precise prognostic insight into the anticipated illness course of children with AGE, informing disposition choices, anticipatory advice, and follow-up treatment.