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Predictability of prognosis of infantile hypernatremic dehydration: a prospective cohort study
Hassan Boskabadi1, Maryam Zakerihamidi2, Ali Moradi3
1Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Insights
Infantile hypernatremic dehydration (IHD) can cause severe brain issues. Key indicators like sodium, urea, and creatinine levels, along with clinical signs, can predict poor outcomes in affected infants.
Area of Science:
- Pediatrics
- Neonatology
- Clinical Research
Background:
- Infantile hypernatremic dehydration (IHD) is a critical condition in newborns.
- It poses significant risks for cerebral complications and mortality.
Purpose of the Study:
- To investigate the prognostic factors and outcomes of infantile hypernatremic dehydration.
- To identify predictors of unfavorable prognosis in infants with IHD.
Main Methods:
- A cohort study involving 183 term infants diagnosed with IHD (serum sodium > 150 mg/dL).
- Data collected via questionnaire and follow-up using the Denver Developmental Screening II test over 36 months.
- Statistical analyses included t-tests, chi-square, regression models, and ROC curve analysis.
Main Results:
- 17.5% of neonates experienced abnormal outcomes.
- Significant differences observed in postpartum breast characteristics, breastfeeding patterns, clinical signs (convulsion, consciousness), urination frequency, and laboratory values (urea, creatinine, sodium) between normal and abnormal outcome groups.
- Brain CT scan findings were also significantly different (p=0.000).
Conclusions:
- Serum sodium, urea, and creatinine levels are highly sensitive and specific indicators for IHD prognosis.
- A combination of clinical and laboratory variables demonstrates a high predictive power (98.6%) for unfavorable outcomes in IHD.
- Identifying these risk factors aids in early intervention and improved management strategies.
Background:
Infantile hypernatremic dehydration (IHD) is a life-threatening disease with potential cerebral adverse effects.
Purpose:
This study was conducted to evaluate the prognosis of IHD.
Methods/Search Strategy:
Using convenience sampling 183 term infants with IHD (Na+ > 150 mg/dl) were enrolled in a cohort study with 36 months follow-up during 2007-2017. A researcher-made questionnaire was used for data collection. Follow-up visits were performed using the Denver Developmental Screening II test after discharging from hospital. The t-test, chi-square test, regression models, and receiver-operating characteristic curve were performed for data analysis.
Findings/Results:
17.5% of neonates were diagnosed with abnormal outcomes. Postpartum breast growth, breastfeeding frequency and duration, convulsion, consciousness, urination frequency, urea, Cr, sodium and brain CT scan (p = .000) showed significant differences (p < .05) between the infants with normal and abnormal outcomes. Combination of the above variables had a high predictive power (98.6%) for determining the unfavorable prognosis in infants with IHD.
Implications For Practice:
Sodium, urea and creatinine are high-sensitive/specific determinants of IHD prognosis. Combination of some risk factors is highly predictive for unfavorable prognosis of IHD.
Implications For Research:
Combination of variables such as sodium, urea, creatinine, lethargy, state of fontanels, convulsion, loss of consciousness, state of the breast during postpartum, inverted nipple and brain CT scan has a high predictive power in the determination of unfavorable prognosis in IHD.
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