Table 4.1Summary characteristics of clinical signs used to detect 5% dehydration

Finding (no. of studies)Total no. of childrenSummary likelihood ratios (with 95% CI) Sensitivity (95% CI)Specificity (95% CI)
Positive (+LR)Negative (−LR)
Prolonged capillary refill (4 )4784.1 (1.7 to 9.8)0.57 (0.39 to 0.82)0.60 (0.29 to 0.91)0.85 (0.72 to 0.98)
Abnormal skin turgor (5)6022.5 (1.5 to 4.2)0.66 (0.57 to 0.75)0.58 (0.40 to 0.75)0.76 (0.59 to 0.93)
Abnormal respiratory pattern (4)5812.0 (1.5 to 2.7)0.76 (0.62 to 0.88)0.43 (0.31 to 0.55)0.79 (0.72 to 0.86)
Sunken eyes (4)5331.7 (1.1 to 2.5)0.49 (0.38 to 0.63)0.75 (0.62 to 0.88)0.52 (0.22 to 0.81)
Dry mucous membranes (4)5331.7 (1.1 to 2.6)0.41 (0.21 to 0.79)0.86 (0.80 to 0.92)0.44 (0.13 to 0.74)
Cool extremity (2)a2061.5, 18.80.89, 0.970.10, 0.110.93, 1.00
Weak pulse (2)a3603.1, 7.20.66, 0.960.04, 0.250.86, 1.00
Absent tears (3)3982.3 (0.9 to 5.8)0.54 (0.26 to 1.13)0.63 (0.42 to 0.84)0.68 (0.43 to 0.94)
Increased heart rate (3)4621.3 (0.8 to 2.0)0.82 (0.64 to 1.05)0.52 (0.44 to 0.60)0.58 (0.33 to 0.82)
Sunken fontanelle (3)3080.9 (0.6 to 1.3)1.12 (0.82 to 1.54)0.49 (0.37 to 0.60)0.54 (0.22 to 0.87)
Poor overall appearance (3)3981.9 (0.97 to 3.8)0.46 (0.34 to 0.61)0.80 (0.57 to 1.00)0.45 (−0.1 to 1.00)
a

Point estimate from individual studies.

From: 4, Assessing dehydration and shock

Cover of Diarrhoea and Vomiting Caused by Gastroenteritis
Diarrhoea and Vomiting Caused by Gastroenteritis: Diagnosis, Assessment and Management in Children Younger than 5 Years.
NICE Clinical Guidelines, No. 84.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2009 Apr.
Copyright © 2009, National Collaborating Centre for Women’s and Children’s Health.

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