Table 1.
Clinical and biochemical characteristics of dehydration severity groups. Mean (SD) or N (%).*†
| Mild (0-<5%) (N = 379) |
Moderate (5-<10%) (N = 343) |
Severe (10% or more) (N = 89) |
Difference Between Moderate & Mild (95% CI) |
Difference Between Severe & Mild (95% CI) |
||
|---|---|---|---|---|---|---|
| Age (years) | 11.8 (3.8) | 11.9 (3.8) | 10.6 (4.1) | 0.1 (−0.5, 0.7) | −1.2 (−2.2, −0.3) | |
| Sex: Male | 157 (41.4%) | 160 (46.6%) | 49 (55.1%) | 5.2% (−2.0, 12.5) | 13.6% (2.2, 25.1) | |
| New onset | 163 (43.0%) | 171 (49.9%) | 57 (64.0%) | 6.8% (−0.4, 14.1) | 21.0% (9.9, 32.2) | |
| Baseline BUN (mg/dL) | 16.1 (6.4) | 16.9 (6.3) | 18.5 (10.5) | 0.9 (−0.1, 1.8) | 2.4 (−0.0, 4.9) | |
| Baseline Creatinine z-score | 0.9 (1.2) | 1.1 (1.4) | 1.5 (1.7) | 0.2 (0.1, 0.4) | 0.6 (0.2, 1.0) | |
| Baseline Glucose-Corrected Sodium (mEq/L) | 140.4 (4.8) | 141.8 (5.3) | 143.1 (6.0) | 1.4 (0.6, 2.1) | 2.7 (1.4, 4.1) | |
| Baseline Bicarbonate (mEq/L) | 9.4 (3.1) | 8.6 (3.2) | 8.3 (3.1) | −0.8 (−1.3, −0.3) | −1.1 (−1.8, −0.4) | |
| Baseline pH | 7.18 (0.09) | 7.15 (0.10) | 7.14 (0.11) | −0.03 (−0.05, −0.02) | −0.04 (−0.07, −0.02) | |
| Baseline Glucose (mg/dL) | 498 (146) | 518 (169) | 553 (166) | 20 (−3, 43) | 55 (17, 93) | |
| Baseline pCO2 (mm Hg) | 26.4 (6.9) | 26.3 (6.8) | 26.5 (9.4) | −0.1 (−1.1, 0.9) | 0.1 (−2.1, 2.3) | |
| Baseline Anion Gap (mEq/L) | 30.9 (5.8) | 33.1 (5.9) | 33.0 (6.6) | 2.2 (1.3, 3.1) | 2.1 (0.5, 3.7) | |
| Baseline Heart Rate z-score‡ | 2.9 (1.7) | 3.1 (1.8) | 3.4 (1.9) | 0.2 (−0.1, 0.5) | 0.5 (−0.0, 0.9) | |
| Baseline Systolic Blood Pressure z-score‡ | 1.3 (1.3) | 1.2 (1.2) | 1.7 (1.2) | −0.1 (−0.3, 0.1) | 0.4 (0.1, 0.7) | |
| Baseline Diastolic Blood Pressure z-score‡ | 0.9 (1.1) | 0.9 (1.0) | 1.4 (1.0) | 0.0 (−0.1, 0.2) | 0.5 (0.3, 0.8) | |
| Capillary refill time evaluated at ED presentation | ||||||
| Not Documented | 14 (3.7%) | 12 (3.5%) | 3 (3.4%) | −0.2% (−2.9, 2.5) | −0.3% (−4.5, 3.9) | |
| < 2 seconds | 224 (59.1%) | 177 (51.6%) | 38 (42.7%) | −7.5% (−14.7, −0.3) | −16.4% (−27.8, −5.0) | |
| 2–5 seconds | 138 (36.4%) | 152 (44.3%) | 46 (51.7%) | 7.9% (0.8, 15.1) | 15.3% (3.8, 26.7) | |
| > 5 seconds | 3 (0.8%) | 2 (0.6%) | 2 (2.2%) | −0.2% (−1.4, 1.0) | 1.5% (−1.8, 4.7) | |
| ED Evaluation GCS Score | ||||||
| 12 | 2 (0.5%) | 1 (0.3%) | 1 (1.1%) | −0.2% (−1.2, 0.7) | 0.6% (−1.7, 2.9) | |
| 13 | 1 (0.3%) | 8 (2.3%) | 3 (3.4%) | 2.1% (0.4, 3.7) | 3.1% (−0.7, 6.9) | |
| 14 | 15 (4.0%) | 22 (6.4%) | 8 (9.0%) | 2.5% (−0.8, 5.7) | 5.0% (−1.2, 11.3) | |
| 15 | 361 (95.3%) | 312 (91.0%) | 77 (86.5%) | −4.3% (−8.0, −0.6) | −8.7% (−16.1, −1.3) | |
| Weight was measured prior to initial IV treatment | 325 (85.8%) | 272 (79.3%) | 70 (78.7%) | −6.5% (−12.0, −0.9) | −7.1% (−16.3, 2.1) | |
| Initial weight z-score adjusted for sex and age‡ | 0.2 (1.1) | −0.2 (1.3) | −0.8 (1.0) | −0.5 (−0.6, −0.3) | −1.0 (−1.2, −0.7) | |
| Discharge weight z-score adjusted for sex and age‡ | 0.4 (1.1) | 0.2 (1.2) | 0.1 (0.9) | −0.2 (−0.4, −0.0) | −0.3 (−0.5, −0.1) | |
| Dehydration severity (% change in body weight from admission to discharge) | 2.9 (1.4) | 7.1 (1.4) | 12.7 (3.5) | 4.2 (4.0, 4.4) | 9.9 (9.1, 10.6) | |
BUN=blood urea nitrogen; ED=emergency department; GCS=Glasgow Coma Scale
†
Number of DKA Episodes with missing values were as follows for mild, moderate, and severe dehydration categories respectively: Baseline BUN, 22, 20, 9; Baseline Creatinine, 22, 20, 10; Baseline Glucose-Corrected Sodium, 13, 7, 3; Baseline Bicarbonate, 10, 7, 2; Baseline pH, 16, 17, 7; Baseline pCO2, 17, 18, 7; Baseline Anion Gap, 29, 29, 9; Baseline Heart Rate z-score, 48, 59, 11; Baseline Systolic and Diastolic Blood Pressure z-scores, 51, 65, 11.
‡
Adjusted for age and sex using reference norms; blood pressure additionally adjusted for height when available.