Falszewska Anna, Dziechciarz Piotr, Szajewska Hania
Department of Paediatrics, The Medical University of Warsaw, Warsaw, Poland.
Department of Paediatrics, The Medical University of Warsaw, Warsaw, Poland
Clin Pediatr (Phila). 2014 Oct;53(12):1181-8. doi: 10.1177/0009922814538493. Epub 2014 Jun 9.
To systematically update diagnostic accuracy of the Clinical Dehydration Scale (CDS) in clinical recognition of dehydration in children with acute gastroenteritis.
Six databases were searched for diagnostic accuracy studies in which population were children aged 1 to 36 months with acute gastroenteritis; index test was the CDS; and reference test was post-illness weight gain.
Three studies involving 360 children were included. Limited evidence showed that in high-income countries the CDS provides strong diagnostic accuracy for ruling in moderate and severe (>6%) dehydration (positive likelihood ratio 5.2-6.6), but has limited value for ruling it out (negative likelihood ratio 0.4-0.55). In low-income countries, the CDS has limited value either for ruling moderate or severe dehydration in or out. In both settings, the CDS had limited value for ruling in or out dehydration <3% or dehydration 3% to 6%.
The CDS can help assess moderate to severe dehydration in high-income settings. Given the limited data, the evidence should be viewed with caution.
系统更新临床脱水量表（CDS）在急性胃肠炎患儿脱水临床识别中的诊断准确性。
检索六个数据库，查找以1至36个月急性胃肠炎患儿为研究对象的诊断准确性研究；索引测试为CDS；参考测试为病后体重增加。
纳入三项涉及360名儿童的研究。有限的证据表明，在高收入国家，CDS对确诊中度和重度（>6%）脱水具有较高的诊断准确性（阳性似然比5.2 - 6.6），但排除脱水的价值有限（阴性似然比0.4 - 0.55）。在低收入国家，CDS在确诊或排除中度或重度脱水方面价值有限。在两种情况下，CDS在确诊或排除<3%脱水或3%至6%脱水方面价值有限。
CDS有助于在高收入环境中评估中度至重度脱水。鉴于数据有限，应谨慎看待该证据。
