• Am J Emerg Med · Nov 2022

    Review

    A systematic review of tools for predicting complications in patients with acute infectious diarrhea.

    • Tania Marx, Claudia Vincent-Boulay, Laurance Marquis-Gendron, Kathryn Bareil, Samuel Leduc, Gabrielle Lefebvre, Catherine Côté, Myriam Mallet, Emmanuelle Paquette-Raynard, Maurice Boissinot, Michel G Bergeron, and Simon Berthelot.
    • Axe Santé des populations et Pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Qc, Canada. Electronic address: tania.marx@univ-fcomte.fr.
    • Am J Emerg Med. 2022 Nov 23; 64: 788578-85.

    ObjectiveTo identify tools that predict the risk of complications in patients presenting to outpatient clinics or emergency departments (ED) with acute infectious diarrhea.MethodsMedline, 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.ResultsFive articles reporting on two different tools were identified. Developed to assess the risk of hospitalization of children, the EsVida scale has not been externally validated. Developed originally to assess the level of dehydration 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 between 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.ConclusionAs 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.Copyright © 2022 Elsevier Inc. All rights reserved.

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