Development and Evaluation of a New Gastroenteritis Clinical Severity Score for Children Aged Under 5.

Abstract

Aim: To develop and internally validate a new severity score to more accurately assess the clinical severity forms of acute gastroenteritis (AGE) in children from birth to age 5 years.

Methods: We included children consulting for AGE in the emergency department of the University Hospital of Nantes (March 2017-June 2019). We developed and evaluated a new predictive score (GASTROVIM score) using the classification and regression trees. We compared its diagnostic performance with the two existing scores: the Vesikari score and clinical dehydration scale (CDS). A clinical expert a posteriori evaluated children's medical records to determine the severity form of AGE as the gold standard.

Results: Of the 200 children included, 129 (64.5%) had severe forms of AGE according to the GASTROVIM score (maximal number of liquid stools and vomiting per day, weight loss and CDS), with sensitivity 90.0% (95% CI: 83.5-94.6) and specificity 82.9% (72.0-90.8). The Vesikari score had similar sensitivity (97.3%) but lower specificity (17.0%) and the CDS had lower sensitivity (28.3%) and higher specificity (100%) than the GASTROVIM score.

Conclusion: The GASTROVIM score could discriminate severe forms of AGE with good diagnostic performance. Nevertheless, external validation in other populations and/or other countries is needed.