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Factors Associated With Actionable Gastrointestinal Panel Results in Hospitalized Children

Erin C Ho1,2, Jillian M Cotter1,3, Jacob Thomas4

  • 1Department of Pediatrics.

Hospital Pediatrics
|November 8, 2023
PubMed

Insights

Gastrointestinal panel (GIP) testing for hospitalized children with acute gastroenteritis (AGE) is more likely to yield actionable results in older children, those with bloody stools, or with international travel history. This can guide testing decisions and reduce unnecessary procedures.

Area of Science:

  • Pediatric Infectious Diseases
  • Clinical Diagnostics
  • Health Services Research

Background:

  • Acute gastroenteritis (AGE) is a common cause of hospitalization in children.
  • The utility of gastrointestinal panel (GIP) testing in hospitalized pediatric patients with AGE is not well-defined.
  • Unnecessary GIP testing can lead to increased healthcare costs and potential overtreatment.

Purpose of the Study:

  • To identify clinical factors and indications for ordering GIP tests associated with actionable results in hospitalized children with AGE.
  • To differentiate factors associated with actionable results in children with and without complex chronic conditions (CCC).

Main Methods:

  • Cross-sectional study of pediatric patients hospitalized with diarrhea and GIP testing between 2015-2018.
  • Multivariable regression analysis to assess associations between actionable GIP results and order indications, stool frequency, and demographics.
  • Analysis stratified by complex chronic conditions (CCC) status.

Main Results:

  • Actionable GIP results were more frequent in non-CCC patients compared to CCC patients.
  • Older age (≥1 year) was associated with actionable results across both groups.
  • In non-CCC patients, bloody stools and non-winter season were linked to actionable results; international travel correlated with non-Clostridioides difficile bacteria and parasites.
  • No specific order indications were associated with actionable results in CCC patients.

Conclusions:

  • Older age, bloody stools, and international travel history can help identify hospitalized children with AGE likely to have actionable GIP results.
  • These findings may improve diagnostic stewardship and reduce unnecessary GIP testing in pediatric populations.
  • Further prospective studies are needed to validate these predictive factors.
Abstract

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