Predicting therapeutic efficacy of oral rehydration salts in children with vasovagal syncope

被引:1
|
作者
Du, Xiaojuan [1 ]
Tao, Chunyan [1 ]
Li, Xueying [2 ]
Du, Junbao [1 ,3 ]
Liao, Ying [1 ]
Jin, Hongfang [1 ]
机构
[1] Peking Univ First Hosp, Dept Pediat, Beijing, Peoples R China
[2] Peking Univ First Hosp, Dept Stat, Beijing, Peoples R China
[3] Peking Univ, State Key Lab Vasc Homeostasis & Remodeling, Beijing, Peoples R China
来源
FRONTIERS IN PEDIATRICS | 2023年 / 11卷
关键词
oral rehydration salts; nomogram; vasovagal syncope; predictive model; body mass index; hematocrit; BLOOD-PRESSURE; HYPOVOLEMIA; VOLUME; VAGAL;
D O I
10.3389/fped.2023.1164304
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
ObjectiveThis study was designed to develop an easy-to-perform and inexpensive measure to predict efficacy of the oral rehydration salts (ORS) in children with vasovagal syncope (VVS).Materials and methodsChildren diagnosed with VVS and treated with ORS for a median of 3 months at the Peking University First Hospital, China, were enrolled and followed up. Demographic data, clinical hemodynamic parameters, and variables related to red blood cells were collected at the baseline. On the basis of changes in symptom scores after treatment, participants were divided into effective or ineffective groups at the end of the follow-up. Logistic regression analysis was used to investigate parameters related to therapeutic efficacy of ORS and a predictive model of ORS effectiveness was created. The predictive efficiency was evaluated using the receiver operating characteristic curve. The accuracy/consistency was evaluated by the Hosmer-Lemeshow test and calibration curve. Internal validation was done using the bootstrap approach.ResultsTotally 97 pediatric participants were included in the study and 4 (4.1%) were lost during the follow-up. ORS therapy was effective in 46 children and ineffective in 47 children. Children in the effective group had higher baseline red blood cell count, hemoglobin, and hematocrit than those in the ineffective group (p < 0.01). Through logistic regression analysis, the baseline hematocrit and body mass index (BMI) were included in predictive model for the response to ORS treatment. The predictive efficacy of the model showed an area under the curve of 0.77 (p < 0.01). The predicted probability cut-off value of 0.5 was found to be optimal, with a resulting sensitivity of 67.4% and specificity of 80.9%. In the Hosmer-Lemeshow test, p-value was 0.75, and the calibration plot showed a good model fitness. Internal validation was performed using the bootstrap approach (n = 1,000), showing 95% confidence interval of 0.67-0.86.ConclusionHemoglobin combined with BMI was useful for predicting the therapeutic efficacy of ORS in children with VVS.
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页数:8
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