The following is a summary of “A systematic review of tools for predicting complications in patients with acute infectious diarrhea,” published in the February 2023 issue of Emergency Medicine by Marx, et al.

For a study, researchers sought to locate instruments to forecast the likelihood of complications in patients with acute infectious diarrhea who visit outpatient clinics or emergency departments (ED).

From the beginning through July 2021, Medline, Embase, Cochrane Library, Web of Science, and CINAHL were searched. For analysis, articles that described creating or validating a score to categorize the likelihood that patients with acute infectious diarrhea in the ED or outpatient clinic may require intravenous rehydration or hospitalization were kept.

There were five articles found that discussed two distinct tools. The EsVida scale, created to evaluate children’s hospitalization risk, had not been independently verified. The Clinical Dehydration Scale (CDS), initially designed to gauge a child’s state of dehydration, had been put to the test as a risk assessment tool. A CDS score of ≥1 had a sensitivity of 0.73 to 0.88 and a specificity of 0.38 to 0.69 for predicting intravenous rehydration. In contrast, a CDS score of ≥5 had a sensitivity of 0.06 to 0.32 and a specificity of 0.94 to 0.99. A CDS score of ≥1 had a sensitivity range of 0.74 to 1.00 and a specificity range of 0.34 to 0.38 for predicting hospitalization. In contrast, a CDS score of 5 had a sensitivity range of 0.26 to 0.62 and a specificity range of 0.66 to 0.96. Meta-analysis was impossible due to the high heterogeneity of studies and the uncertain risk of bias.

Only for children had the CDS been verified as a risk-stratification tool. To create and evaluate a tool appropriate for adult patients in the ED.

Reference: sciencedirect.com/science/article/pii/S073567572200729X