Related Experiment Video
Updated: Jan 19, 2026
Author Spotlight: Simulation and Analysis of the Temperature Rise of Ring Main Unit Equipment
Published on: July 5, 2024
A prospective comparative study of children with gastroenteritis: emergency department compared with symptomatic care
Otto G Vanderkooi1, Jianling Xie2, Bonita E Lee3
1Departments of Pediatrics, Microbiology, Immunology and Infectious Diseases, Pathology & Laboratory Medicine and Community Health Sciences and the Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.
Insights
Children with gastroenteritis treated at home experience more diarrhea, while those in emergency departments (EDs) have more vomiting episodes. Norovirus is more prevalent in community-treated children, indicating a significant disease burden.
Area of Science:
- Pediatric infectious diseases
- Epidemiology of viral illnesses
- Gastroenteritis in children
Background:
- Gastroenteritis is a common childhood illness, but its epidemiology and severity differ between children managed at home versus those seeking emergency department (ED) care.
- Understanding these differences is crucial for accurate diagnosis and resource allocation.
Purpose of the Study:
- To compare the severity and causes of gastroenteritis in children receiving emergency department (ED) care versus those managed at home (community cohort).
- To identify differences in symptoms, pathogens, and healthcare utilization between the two groups.
Main Methods:
- A prospective cohort study enrolled 1613 children from two pediatric EDs and via telephone triage for home management in Alberta, Canada (December 2014–December 2016).
- Primary outcomes included maximal vomiting and diarrhea frequency in 24 hours; secondary outcomes involved pathogens, dehydration, and healthcare visits.
- Statistical analysis, including regression, compared illness characteristics between ED and community cohorts.
Main Results:
- The ED cohort reported higher maximal vomiting frequency (P < 0.001), while the community cohort had a higher proportion of children with diarrhea and greater diarrheal frequency (P < 0.001).
- Regression analysis indicated more vomiting episodes in the ED cohort (IRR 1.25) and more diarrheal episodes in the community cohort (IRR 1.20).
- Norovirus was significantly more frequent in the community cohort (36.8% vs. 23.6%; P < 0.001).
Conclusions:
- Children presenting to EDs for gastroenteritis experience more vomiting, whereas those managed at home experience more diarrhea.
- Norovirus is a more common cause of gastroenteritis in children treated symptomatically at home, suggesting a greater disease burden than previously recognized.
- These findings highlight distinct clinical profiles and etiological differences based on healthcare-seeking behavior for pediatric gastroenteritis.
Abstract:
Little is known about the epidemiology and severity of gastroenteritis among children treated at home. We sought to compare illness severity and etiology between children brought for emergency department (ED) care to those managed at home (i.e., community). Prospective cohort study of children enrolled between December 2014 and December 2016 in two pediatric EDs in Alberta, Canada along with children treated at home after telephone triage (i.e., community). Primary outcomes were maximal frequency of vomiting and diarrhea in the 24-h pre-enrollment period; secondary outcomes included etiologic pathogens, dehydration severity, future healthcare visits, and treatments provided. A total of 1613 patients (1317 ED, 296 community) were enrolled. Median maximal frequency of vomiting was higher in the ED cohort (5 (3, 10) vs. 5 (2, 8); P < 0.001). Proportion of children with diarrhea and its 24-h median frequency were lower in the ED cohort (61.3 vs. 82.8% and 2 (0, 6) vs. 4 (1, 7); P < 0.001, respectively). In regression analysis, the ED cohort had a higher maximum number of vomiting episodes pre-enrollment (incident rate ratio (IRR) 1.25; 95% CI 1.12, 1.40) while the community cohort had higher maximal 24-h period diarrheal episodes (IRR 1.20; 95% CI 1.01, 1.43). Norovirus was identified more frequently in the community cohort (36.8% vs. 23.6%; P < 0.001). Children treated in the ED have a greater number of vomiting episodes; those treated at home have more diarrheal episodes. Norovirus is more common among children treated symptomatically at home and thus may represent a greater burden of disease than previously thought.
Related Concept Videos
04:35Comparative Study of Simulation of Temperature Rise in Ring Main Unit
02:26Comparing Copy Number Variations and SNPs
Copy number variations or CNVs are the structural variations that cover more than 1kb of DNA sequence. The single nucleotide polymorphism (SNP), on the other hand, is a single nucleotide change or a point mutation that is found in more than 1%...
14:14The Innovation Arena: A Method for Comparing Innovative Problem-Solving Across Groups
05:32Comparing Eye-tracking Data of Children with High-functioning ASD, Comorbid ADHD, and of a Control Watching Social Videos
04:05Clinical Application of Phase Angle and BIVA Z-Score Analyses in Patients Admitted to an Emergency Department with Acute Heart Failure
07:52Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department