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Experience with diarrheal disease in a university pediatric hospital
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Oral rehydration therapy (ORT) effectively treated 94.7% of infant diarrhea cases at Istanbul University Children's Hospital. Establishing dedicated Diarrhea Units can save lives and reduce hospital admissions.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Diarrheal disease (DD) is a significant cause of infant morbidity.
- Coexisting infections complicate a substantial number of pediatric diarrhea cases.
Purpose of the Study:
- To evaluate the effectiveness of oral rehydration therapy (ORT) in managing pediatric diarrhea.
- To assess the impact of Diarrhea Units on patient outcomes and hospital resource utilization.
Main Methods:
- Retrospective analysis of 3227 diarrhea cases presenting at a children's hospital outpatient department.
- Implementation of ORT in a dedicated Diarrhea Unit for non-severe cases.
- Identification of criteria for intravenous (IV) therapy.
Main Results:
- 94.7% of patients successfully rehydrated with ORT.
- Indications for IV therapy included severe dehydration, shock, severe systemic infection, and failure of enteral rehydration.
- Overall mortality rate was 11%.
Conclusions:
- Widespread implementation of ORT is effective in managing pediatric diarrhea.
- Establishing Diarrhea Units can improve patient survival and reduce healthcare costs through decreased admissions.
Abstract:
In 1987, 3227 diarrhea cases, half of which were infants, presented at the Out-patient Department of the Istanbul University Children's Hospital. An examination of these cases showed that in 1,066 cases diarrheal disease (DD) was accompanied by a coexisting infection or other disease. The cases with severe dehydration, shock or severe systemic disease were immediately hospitalized. All the remaining cases were administered oral rehydration therapy (ORT) in the Diarrhea Unit, and 94.7 percent of them were successfully rehydrated with ORT. Severe dehydration, shock, severe systemic infection, abdominal distention, failure of rehydration by the enteral route, severe protein energy malnutrition (PEM), and the presence of convulsions were the indications for i.v. therapy. The overall mortality rate was 11 percent. Our experience with DD indicates that widespread implementation of ORT in diarrheal disease and the establishment of Diarrhea Units in large hospitals will contribute not only to saving more lives but will also have an economic impact by reducing the number of admissions.