Table 3.
Regression Analysis: Risk Factors Associated With Development of Hemolytic Uremic Syndrome and Need for Renal Replacement Therapy
| Hemolytic Uremic Syndrome (n = 464) |
Renal Replacement Therapy (n = 464) |
|||
|---|---|---|---|---|
| Risk Factor | Adjusted OR (95% CI) |
P Value | Adjusted OR (95% CI) |
P Value |
| Sex, female | 1.64 (.93–2.90) | .09 | 2.27 (1.14–4.50) | .02 |
| Age (per year increase) | 0.77 (.69–.85) | <.001 | 0.83 (.74–.92) | <.001 |
| Received antibiotics (yes)a | 1.11 (.41–2.97) | .84 | 1.52 (.51–4.51) | .45 |
| Vomiting (yes) | 1.59 (.90–2.81) | .11 | 1.46 (.74–2.88) | .27 |
| Time from start of diarrhea to first ED visit (per day) | 0.70 (.54–.90) | .005 | 0.83 (.67–1.02) | .07 |
| Hematochezia (yes) | 1.03 (.47–2.25) | .94 | 0.68 (.29–1.57) | .37 |
| Signs of dehydrationb (yes) | 1.20 (.67–2.16) | .55 | 1.00 (.50–2.00) | .99 |
| WBC count ≥13 × 103/μL | 2.54 (1.42–4.54) | .002 | 2.35 (1.17–4.72) | .02 |
| Hematocrit (per 5% increase) | 1.83 (1.21–2.77) | .004 | 1.26 (.81–1.97) | .30 |
| Platelet count <250 × 103/μL | 1.92 (1.02–3.60) | .04 | 1.49 (.72–3.07) | .28 |
| Serum creatinine (per 1 mg/dL increase) | 10.82 (1.49–78.69) | .02 | 7.75 (1.2–50.16) | .03 |
| Serum sodium (per 1 mmol/L decrease) | 1.12 (1.02–1.23) | .01 | 1.15 (1.04–1.27) | .007 |
| Initiation of IVF administrationc | ||||
| None or IVF before day 4 of diarrhea | 1 (Reference) | 1 (Reference) | ||
| On or after day 4 of diarrhea | 2.50 (1.14–5.46) | .02 | 2.71 (1.18–6.21) | .02 |
Complete data available for 464 participants without HUS at index visit. Model diagnostic statistics for HUS: –2 log likelihood = 336.882, χ2 = 128.045, degrees of freedom (df) = 13, P < .001; Nagelkerke R2 = 0.381; classification percentage, 84.9%; Hosmer-Lemeshow test P = .674; largest variance inflation factor (VIF) = 1.862. Model diagnostic statistics for renal replacement therapy: –2 log likelihood = 263.654, χ2 = 89.861, df = 13, P < .001; Nagelkerke R2 = 0.330; classification percentage, 89.2%; Hosmer-Lemeshow test P = .260; largest VIF = 1.862.
Abbreviations: CI, confidence interval; ED, emergency department; IVF, intravenous fluid; OR, odds ratio; WBC, white blood cell.
aFor children with HUS, variable includes antibiotics received before HUS criteria were met.
bSigns of dehydration defined by: dehydrated, dry-appearing, dry mucous membranes, tented skin, sunken eyes, decreased perfusion, or other similar terms.
cFor children with HUS, variable includes IVF before HUS criteria were met.