Table 2a.
Multivariable multinomial regression models predicting dehydration severity based on characteristics at presentation, including only those DKA episodes for whom weight was measured prior to initial IV treatment. *
| Odds-Ratios (95% Confidence Intervals) † |
||||
|---|---|---|---|---|
| Partially Adjusted Models | Final Adjusted Model | |||
| Moderate vs Mild | Severe vs Mild | Moderate vs Mild | Severe vs Mild | |
| Clinical Criteria | ||||
| New Onset (vs. previously | 1.34 (0.94, 1.92) | 1.87 (1.04, 3.36) | 1.76 (1.00, 3.10) | 2.68 (1.04, 6.87) |
| diagnosed) ‡ | ||||
| Diastolic Blood Pressure (z-score) ⁋ | 0.98 (0.82, 1.17) | 1.49 (1.12, 1.98) | 1.01 (0.78, 1.31) | 1.96 (1.23, 3.14) |
| Capillary refill time ≥ 2 seconds (vs. <2) | 1.33 (0.95, 1.85) | 1.86 (1.09, 3.18) | 0.83 (0.54, 1.28) | 1.48 (0.70, 3.10) |
| Systolic Blood Pressure (z-score) ⁋ | 0.91 (0.78, 1.04) | 1.10 (0.88, 1.38) | 0.85 (0.69, 1.03) | 0.80 (0.55, 1.16) |
| Sex: Male (vs. Female) ‡ | 1.09 (0.78, 1.51) | 1.73 (1.03, 2.93) | 0.87 (0.58, 1.32) | 1.13 (0.55, 2.33) |
| Heart Rate (z-score) ⁋ | 1.09 (0.98, 1.21) | 1.33 (1.12, 1.58) | 0.99 (0.86, 1.15) | 1.11 (0.86, 1.43) |
| Age (years) ‡ | 1.02 (0.98, 1.07) | 0.95 (0.89, 1.02) | 1.03 (0.97, 1.10) | 0.99 (0.89, 1.10) |
| Laboratory Criteria | ||||
| Glucose-corrected Sodium (mEq/L) | 1.08 (1.04, 1.12) | 1.15 (1.09, 1.21) | 1.04 (0.99, 1.10) | 1.12 (1.03, 1.21) |
| pH (0.1 units) | 0.69 (0.57, 0.82) | 0.62 (0.47, 0.82) | 0.74 (0.57, 0.96) | 1.11 (0.70, 1.74) |
| BUN (mg/dL) | 1.03 (1.00, 1.06) | 1.07 (1.02, 1.12) | 1.02 (0.97, 1.06) | 1.09 (1.01, 1.16) |
| Creatinine(z-score) ⁋ | 1.28 (1.09, 1.50) | 1.57 (1.24, 1.99) | 1.07 (0.86, 1.34) | 1.08 (0.74, 1.57) |
| Glucose (per 100 mg/dL increase) | 1.09 (0.97, 1.21) | 1.19 (1.02, 1.40) | 0.91 (0.78, 1.06) | 0.95 (0.75, 1.20) |
| pCO2 (mm Hg) | 0.99 (0.97, 1.02) | 0.99 (0.95, 1.03) | 1.00 (0.96, 1.03) | 0.96 (0.90, 1.02) |
| Anion Gap (mEq/L) | 1.09 (1.06, 1.13) | 1.11 (1.06, 1.17) | 1.06 (1.02, 1.11) | 1.04 (0.96, 1.12) |
| Bicarbonate (mEq/L) | 0.89 (0.84, 0.94) | 0.90 (0.82, 0.99) | ‡ | ‡ |
BUN=blood urea nitrogen
Complete data were available for 476 of 667 visits and were included in the final adjusted model.
Odds ratios are estimating the change in odds of moderate or severe dehydration versus mild dehydration based on a one- unit change in the predictor except where indicated. All predictors were measured at baseline prior to treatment initiation. Clinical and laboratory criteria are sorted separately by descending absolute log odds ratio comparing severe vs. mild dehydration in the final adjusted model.
Age, sex and new onset of diabetes were included in partially adjusted models. Partially adjusted results for age, sex and new onset are from a multivariable model with those three variables. The final adjusted model included all variables shown; bicarbonate was excluded due to correlation with pH
Z-scores were calculated as (observed –expected)/standard deviation, where a 1 unit change is equal to a 1 standard deviation change. Expected mean diastolic blood pressure values range from 35 to 77 mm Hg depending on age, sex and height, with an assumed standard deviation ranging from 11.0 to 11.6; expected systolic blood pressure values range from 78 to 127 mm Hg depending on age, sex and height, with an assumed standard deviation ranging from 10.5 to 10.7; expected heart rate values range from 69 to 127 beats/min depending on age and sex, with an assumed standard deviation of 12; expected creatinine values range 0.26 mg/dL for the youngest patients to 0.6 mg/dL for children 14 years old and older, with an assumed standard deviation of 0.2143.