Clinical characteristics associated with increased resource utilization of hospitalized children under 5 years with acute gastroenteritis at a tertiary hospital in the northern region of Ghana: a retrospective study.

Content Provider	Europe PMC
Author	Abdul-Mumin, Alhassan Ervin, Sean Halvorson, Elizabeth Eby
Copyright Year	2019
Abstract	IntroductionAcute gastroenteritis (AGE) is a leading cause of mortality in children in developing countries. Management of AGE consumes medical resources, including antibiotics and intra-venous fluids, but factors affecting resource utilization in the management of AGE are under-studied. We hope to identify clinical predictors of resource utilization in AGE.MethodsWe performed a retrospective chart review of patients 1-60 months of age admitted to a tertiary hospital in Northern Ghana between January 2013 and December 2014 with an admitting diagnosis of AGE. We collected data on patient demographics, presenting symptoms, and subsequent management. Our primary outcome was prolonged hospital length of stay, defined as >4 days. Secondary outcomes included other measures of resource utilization, such as use of antibiotics, antimalarials and intravenous fluids. Demographic and clinical characteristics were compared between groups with Pearson chi square test for categorical variables and ANOVA for continuous variables. Multivariable logistic regression modeling for each outcome included all variables found to be significant in the bivariate analysis.ResultsWe reviewed charts for 473 patients admitted for AGE during this timeframe. 264 (56%) were male, median age was 12 months. 448 (95%) received antibiotics, 396 (84%) received antimalarials and 365 (77.2%) received intravenous fluids. 167 (35.3%) had prolonged LOS >4 days. Following multiple logistic regression analysis, clinical features associated with prolonged LOS included fever duration (OR 2.87, 95% CI 2.28-3.61 per 1-day increase), mild (OR 2.39, 95% CI 1.12-5.08) or moderate (OR 3.13, 95% CI 1.57-6.21) dehydration (compared to none) and symptom duration (OR 1.13, 95% CI 1.01-1.27 per 1-day increase).ConclusionDehydration and duration of symptoms prior to presentation predict prolonged hospital LOS in young children with AGE in Northern Ghana.
Journal	The Pan African Medical Journal
Volume Number	33
PubMed Central reference number	PMC6756856
PubMed reference number	31565146
e-ISSN	19378688
DOI	10.11604/pamj.2019.33.186.13133
Language	English
Publisher	The African Field Epidemiology Network
Publisher Date	2019-07-11
Access Restriction	Open
Rights License	The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © Alhassan Abdul-Mumin et al.
Subject Keyword	Acute gastroenteritis low resource setting resource utilization length of stay
Content Type	Text
Resource Type	Article
Subject	Medicine