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688 Are the 2009 Espghan/Espid’S Recommendations in Acute Gastroenteritis used Correctly?
  1. H Antunes1,
  2. D Farinha2,
  3. V Baptista3
  1. 1Gastroenterology, Hepatology and Nutrition Unit, Pediatric Department, Braga Hospital, Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, ICVS/3B’s - PT Government Associate Laboratory
  2. 2Gastroenterology, Hepatology and Nutrition Unit, Pediatric Department, Braga Hospital
  3. 3Pediatric Department, Braga Hospital, Braga, Portugal

Abstract

Background The ESPGHAN/ESPID acute gastroenteritis (AGE) recommendations management were published in 2009.

Aim Study these recommendations in a tertiary hospital ER during rotavirus (RV) season.

Material and Methods Retrospective, observational and analytical study, from January 1 to April 30, 2010, in younger than 18 years old, admitted at the ER with criteria for AGE(>3 stools in the last 24 hours).

Results From the 13 780 children admitted in ER, 770 had AGE (incidence 5.6%). Were male 57.1%, 93.5% came without prior referral and 91.5% didn’t take Oral Rehydration Solution (ORS). Had fever 34.2%, 68.7% vomit and 10.9% dehydration. At the ER, the ORS was administered in 62.1%. Diagnostic tests were not performed in 63.8%; 4.4% were admitted at the observations room; 0.3% at the pediatric department. Age was significantly associated with use of ORS (ORS: 42.84±45.16 months vs “no ORS”: 87.16±64.61, p<0,001). The ORS was prescribed to 68.2%, “not recommended” drugs in 63 cases and more often in older children (“not recommended” 67.05±60.46 vs “no medication”: 49.60±49.33 months, p=0,038). Blood analyses were performed in 6.4% and in children significantly older (85.57±65.62vs 51.89±54.49 months, p<0,001). Similar results were observed for the urine dipstick (85.57±65.62 vs 54.14±49.51, p=0,002), stool (85.57±65.62vs28.16±38.50, p=0,008) and stool/blood (85.57±65.62vs13.45± 13.85, p<0,001). At discharge, diet changes were recommended in 37% children.

Conclusion AGE incidence was 5.6%. Management was most based on ESPGHAN/ESPID’s recommendations. There was still an inappropriate use of drugs and diet changes. The use of ORS before referral to the ER was rare.

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