Factors Related to Dehydration in Children Admitted to the Emergency Department: A Cross-Sectional Study

Abstract

Background: Dehydration is a significant cause of mortality in children under 5 years of age worldwide. Various factors contribute to dehydration in children, making it essential to understand its associated risk factors. Objectives: The aim of this cross-sectional study was to investigate factors related to dehydration in children admitted to the emergency department. Methods: In this cross-sectional study, all children under 18 years of age with moderate to severe dehydration who were referred to the emergency department of Amirkola Hospital in Babol, located in the northern region of Iran, were assessed from May 1 to September 15, 2023. Participants were included in the study if they met the inclusion criteria. The data were gathered from the patients' medical records using a three-part questionnaire consisting of demographic characteristics, basic factors, and associated clinical symptoms. After data gathering, the data were entered into Stata 17 software and analyzed using statistical tests at a significance level of P < 0.05. Results: Of the 141 children studied, 61% visited the emergency department 48 hours after the onset of diarrhea symptoms. Approximately 71% used home remedies to manage diarrhea symptoms. Notably, 60% of parents were unaware of oral rehydration solution (ORS) treatment. Most children had symptoms of fever (71%), vomiting (69.5%), abnormal skin turgor (61.7%), lack of tears (95.7%), oliguria (35.7%), paleness (48.2%), and abdominal distention (30.5%). Children with a history of travel (adjusted OR, 3.74; 95% CI, 1.13 - 12.34) and those with underlying medical conditions (adjusted OR, 4.41; 95% CI, 1.09-17.75) were at a higher risk of abdominal distention. Moreover, children whose mothers did not wash their hands before preparing food were at increased risk of diarrhea (RR, 1.48; 95% CI, 0.98 - 2.33) and abdominal distention (RR, 0.39; 95% CI, 0.15 - 0.95). Conclusions: The findings of this study indicate that the majority of children go to the emergency department late to receive treatment. Factors such as a history of travel, underlying medical conditions, and poor hand hygiene practices before preparing food are significantly associated with dehydration in children. Therefore, it is recommended to include preventive educational interventions to prevent dehydration and encourage early referral in family educational programs.