DESIGN Nested case-control study.
SETTING De La Salle University Medical Center and Dr. J.P. Rizal Memorial Hospital, Dasmarinas, Cavite
PATIENTS Eighty patients aged more than 1 month to 24 months with Acute Diarrhea with Severe Dehydration based on World Health Organization (WHO) Classification
METHODS The subjects were divided into two groups according to their clinical evolution: Cases-Died and Control-Survived. Univariate analysis using odds ratio was used to analyzed the following variables: age, gender, nutritional status, type of diarrhea, frequency of diarrhea, vomiting, seizure, serum levels of sodium and potassium, previous history of admissions due to diarrhea, duration of diarrhea prior to admission, previous consult prior to admission, intake of oral rehydration salt (ORS) solution, last urine output prior to admission, breastfeeding history, and concomitant illness. Significant variables were further analyzed using multiple logistic regression.
RESULTS In the univariate analysis the following variables were found to be significant: seizure, hypokalemia, hyponatremia, duration of diarrhea prior to admission, last urine output prior to admission, and concomitant illness. In the multivariate analysis, hypokalemia and seizure retained their significance.
CONCLUSION Hyponatremia, duration of diarrhea and last urine output prior to admission, and presence of concomitant illness are important risk factors associated with mortality among infants with acute diarrhea with severe dehydration. However, our data suggest that hypokalemia and seizure are associated with significantly increased risk of mortality in this sample population.