Korean J Pediatr Infect Dis.  2014 Apr;21(1):43-52.

Comparison among Known Severity Scoring Scales in the Evaluation of Acute Gastroenteritis in Children

Affiliations
  • 1Department of Pediatrics, College of Medicine, The Catholic University of Seoul, Korea. jh00mn@catholic.ac.kr
  • 2Department of Pediatrics, College of Medicine, Inje University of Pusan, Korea.
  • 3Department of Pediatrics, College of Medicine, Yonsei University of Wonju, Korea.
  • 4Department of Pediatrics, College of Medicine, Busan National University, Busan, Korea.
  • 5Department of Pediatrics, College of Medicine, Chonbuk National University of Jeonju, Korea.
  • 6Department of Pediatrics, Changwon Fatima Hospital, Changwon, Korea.
  • 7Division of Vaccine Research, Center for Infectious Diseases, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongwon, The Republic of Korea.

Abstract

PURPOSE
This study aimed to evaluate the disease severity of children suffering from gastroenteritis using different scales. The results are compared and subsequently classified on the basis of the type of virus causing the disease in order to investigate the differences in clinical characteristics and disease severity according to pathogen. METHOD: This study was conducted prospectively with patients under 5 years of age diagnosed with acute gastroenteritis and hospitalized at 9 medical institutions in 8 regions across the Republic of Korea. Disease severity was evaluated using the Vesikari Scale, the Clark Scale, and the modified Flores Scale. Fecal samples collected from patients were used to detect rotavirus and enteric adenovirus by enzyme immunoassay, and for RT-PCR of norovirus, astrovirus, and sapovirus.
RESULTS
There were a total of 214 patients with a male : female ratio of 1.58 : 1, of which 35 were under the age of 6 months (16.4%), 105 were aged 6-23 months (49.1%), and 74 were aged 24-59 months (34.5%). The rate of concordance between the Vesikari and Clark Scales was 0.521 (P<0.001) and, in severe cases, the Vesikari Scale was 60.7% and Clark Scale was 2.3%, indicating that the Clark Scale was stricter in the evaluation of severe cases.
CONCLUSIONS
In children with gastroenteritis, there were differences in disease severity based on the scale used. Therefore, to achieve consistent results among researchers, either only a single scale or a measure of all scales should be used to determine disease severity.

Keyword

Gastroenteritis; Clinical scoring system; Child

MeSH Terms

Adenoviridae
Child*
Female
Gastroenteritis*
Humans
Immunoenzyme Techniques
Male
Norovirus
Prospective Studies
Republic of Korea
Rotavirus
Sapovirus
Weights and Measures*

Figure

  • Fig. 1 Detection status of causative viruses in 214 acute gastroenteritis episodes in admitted children <5 years old.


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