Background Although oral rehydration guidelines are widely implemented, some children with acute gastroenteritis (AGE) at the emergency department (ED) fail standardised oral rehydration therapy.
Aim To identify predictors for failure of oral rehydration in children with AGE.
Methods Design prospective, observational study.
Setting ED Erasmus University Medical Centre – Sophia Children’s Hospital, 2010- 2012.
Patients Children 1 month- 5 years of age with AGE.
Outcome Failure of oral rehydration, defined by 1) nasogastric tube (NGT) rehydration after oral rehydration was primarily started, 2) intravenous rehydration, 3) hospitalisation, all at initial visit or 4) revisit within 72 h after discharge from the ED.
Of 225 included patients (99.5% mild to moderately dehydrated): 44 patients failed oral rehydration (50.0% male, median age 1.07 (IQR 0.8–2.0), 181 patients were successfully rehydrated (54.1% male, median age 1.8 (IQR 0.9–2.4). There were no differences in age, vital signs or dehydration score between successfully and failed rehydrated patients. Patients in whom rehydration failed complained significantly more often of vomiting (p 0.01) and were in a higher triage urgency category (p 0.07) at initial presentation.
MTS urgency level (OR 0.3 CI 95% 0.09–0.83) and vomiting > 4 times/ day were predictors of failure (OR 0.4 CI 95% 0.13–1.0), age and diarrhoea frequency were not.
Conclusion In young children with AGE who failed oral rehydration at the ED, MTS urgency and vomiting > 4 times/ day were predictors of failure, in contrast to age and diarrhoea frequency.