- Journal
- AMERICAN JOURNAL OF EMERGENCY MEDICINE
- Année
- 2023
- Volume
- 64
- Pages
- 78-85
- Mois
- FEB
- DOI
- 10.1016/j.ajem.2022.11.024
Abstract
Objective: To identify tools that predict the risk of complications in patients presenting to outpatient clinics or emergency departments (ED) with acute infectious diarrhea. Methods: Medline, Embase, Cochrane Library, Web of Science and CINAHL were searched from inception to July 2021. Articles reporting on the derivation or validation of a score to stratify the risk of intravenous rehydration or hospitalization among patients with acute infectious diarrhea in the ED or outpatient clinic were retained for analysis. Results: Five articles reporting on two different tools were identified. Developed to assess the risk of hospitaliza-tion of children, the EsVida scale has not been externally validated. Developed originally to assess the level of de-hydration in children, the Clinical Dehydration Scale (CDS) was evaluated as a risk stratification tool. For predicting intravenous rehydration, a CDS score >= 1 showed a sensitivity between 0.73 and 0.88 and specificity between 0.38 and 0.69, whereas a CDS score >= 5 showed a sensitivity between 0.06 and 0.32 and specificity be-tween 0.94 and 0.99. For predicting hospitalization, a CDS score >= 1 showed a sensitivity between 0.74 and 1.00 and specificity between 0.34 and 0.38, whereas a CDS score >= 5 showed a sensitivity between 0.26 and 0.62 and specificity between 0.66 and 0.96. High heterogeneity among studies and unclear risk of bias precluded meta-analysis. Conclusion: As a risk-stratification tool, the CDS has been validated only for children. Further research is needed to develop and validate a tool suitable for adults in the ED. (c) 2022 Elsevier Inc. All rights reserved.