Gravel J, Manzano S, Guimont C, Lacroix L, Gervaix A, Bailey B
Département de pédiatrie, CHU Sainte-Justine, chemin Côte-Sainte-Catherine, Montréal, Québec, Canada.
Arch Pediatr. 2010 Dec;17(12):1645-51. doi: 10.1016/j.arcped.2010.09.009. Epub 2010 Oct 14.
Dehydration is an important complication for sick children. The Clinical Dehydration Scale for children (CDS) measures dehydration based on 4 clinical signs: general appearance, eyes, saliva, and tears.
To validate the association between the CDS and markers of dehydration in children aged 1 month to 5 years visiting emergency departments (EDs) for vomiting and/or diarrhea.
An international prospective cohort study conducted in 3 university-affiliated EDs in 2009. Participants were a convenience sample of children aged 1-60 months presenting to the ED for acute vomiting and/or diarrhea. Following triage, a research nurse obtained informed consent and evaluated dehydration using the CDS. A few days after recovery, another research assistant weighed participants at home. The primary outcome was the percentage of dehydration calculated by the difference in weight at first evaluation and after recovery. Secondary outcomes included proportion of blood test measurements, intravenous use, hospitalization, and inter-rater agreement.
During the study period, 264 children were recruited and data regarding weight and dehydration scores were complete for 219 (83%). According to the CDS, 88 had no dehydration, 159 some dehydration, and 15 moderate or severe dehydration. A Chi-square test showed a statistical association between CDS and weight gain, the occurrence of blood tests, intravenous rehydration, hospitalization, and abnormal plasmatic bicarbonate. Good inter-rater correlation was found among participants (linear weighted Kappa score of 0.65; (95% CI, 0.43-0.87).
CDS categories correlate with markers of dehydration for young children complaining of vomiting and/or diarrhea in the ED.
脱水是患病儿童的一种重要并发症。儿童临床脱水量表（CDS）基于一般外观、眼睛、唾液和眼泪这4种临床体征来衡量脱水情况。
验证1至5岁因呕吐和/或腹泻前往急诊科（ED）就诊的儿童中，CDS与脱水标志物之间的关联。
2009年在3家大学附属医院的急诊科开展了一项国际前瞻性队列研究。参与者是因急性呕吐和/或腹泻到急诊科就诊的1至60个月儿童的便利样本。分诊后，一名研究护士获得知情同意，并使用CDS评估脱水情况。康复几天后，另一名研究助理在家中对参与者进行称重。主要结局是通过首次评估时与康复后的体重差异计算出的脱水百分比。次要结局包括血液检测指标比例、静脉补液使用情况、住院情况以及评分者间一致性。
研究期间，招募了264名儿童，其中219名（83%）的体重和脱水评分数据完整。根据CDS，88名无脱水，159名有轻度脱水，15名有中度或重度脱水。卡方检验显示CDS与体重增加、血液检测的发生、静脉补液、住院以及血浆碳酸氢盐异常之间存在统计学关联。参与者之间发现了良好的评分者间相关性（线性加权Kappa评分为0.65；（95%CI，0.43 - 0.87））。
对于在急诊科主诉呕吐和/或腹泻的幼儿，CDS类别与脱水标志物相关。
