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Predictors of Mortality in Children Admitted to the Pediatric Intensive Care Unit with Acute Gastroenteritis with Severe Dehydration

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Abstract

The objective of the present study was to identify risk factors for mortality at admission in children admitted to the Pediatric Intensive Care Unit (PICU) with acute gastroenteritis (AGE) with severe dehydration and shock. This was a retrospective chart review of all cases of AGE with severe dehydration and shock admitted to the PICU from 2012 to 2017. Children who died during hospital stay were compared with those who survived. A total of 62 children were admitted with AGE to the PICU during this period. Twenty-four children (39%) died. The following variables were found to be significantly associated with death on univariate analysis: clinical pallor (p = 0.01), thrombocytopenia (p = 0.018), elevated leucocyte count (p = 0.02), hypoalbuminemia (p = 0.02) and severe acute malnutrition (SAM) (p = 0.04). On multivariate analysis, only hypoalbuminemia {RR [95% CI: 2.6 (1.27 to 9.21)]; 0.039} and SAM {RR [95% CI: 4.9 (1.12 to 10)]; 0.045} remained statistically significant. Children admitted with severe dehydration and shock had high mortality rates. These children were a sicker subset with probable sepsis. Severe acute malnutrition and hypoalbuminemia were associated with increased risk of death in these patients.

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Authors and Affiliations

  1. Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India

    Man Singh, Jhuma Sankar, Arvind Kumar, U. Vijay Kumar, Rakesh Lodha & Sushil K. Kabra

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  1. Man Singh
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  2. Jhuma Sankar
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  3. Arvind Kumar
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  4. U. Vijay Kumar
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  5. Rakesh Lodha
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  6. Sushil K. Kabra
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Contributions

JS, RL, SKK conceptualized, designed the study and developed the protocol. MS, AK, and UVK collected the data and helped with the review of the literature and writing the manuscript. JS performed the statistical analysis and wrote the manuscript. All authors approved the final versions of the manuscript. SKK will act as guarantor for this paper.

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Correspondence to Jhuma Sankar.

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Singh, M., Sankar, J., Kumar, A. et al. Predictors of Mortality in Children Admitted to the Pediatric Intensive Care Unit with Acute Gastroenteritis with Severe Dehydration. Indian J Pediatr 86, 1142–1145 (2019). https://doi.org/10.1007/s12098-019-03094-0

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  • DOI: https://doi.org/10.1007/s12098-019-03094-0

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