Affiliation:
1. Rady Children’s Hospital, San Diego, California, and University of California San Diego, San Diego, California
Abstract
BACKGROUND AND OBJECTIVES
Acute gastroenteritis (AGE) is a common health care problem accounting for up to 200 000 pediatric hospitalizations annually. Previous studies show disparities in the management of children from different ethnic backgrounds presenting to the emergency department with AGE. Our aim was to evaluate whether differences in medical management also exist between Hispanic and non-Hispanic children hospitalized with AGE.
METHODS
We performed a single-center retrospective study of children aged 2 months to 12 years admitted to the pediatric hospital medicine service from January 2016 to December 2020 with a diagnosis of (1) acute gastroenteritis or (2) dehydration with feeding intolerance, vomiting, and/or diarrhea. Differences in clinical pathway use, diagnostic studies performed, and medical interventions ordered were compared between Hispanic and non-Hispanic patients.
RESULTS
Of 512 admissions, 54.9% were male, 51.6% were Hispanic, and 59.2% were on Medicaid. There was no difference between Hispanic and non-Hispanic patients in reported nausea or vomiting at admission, pathway use, or laboratory testing including stool studies. However, after adjusting for covariates, Hispanic patients had more ultrasound scans performed (odds ratio 1.65, 95% confidence interval 1.04–2.64) and fewer orders for antiemetics (odds ratio 0.53, 95% CI 0.29–0.95) than non-Hispanic patients.
CONCLUSIONS
Although there were no differences in many aspects of AGE management between Hispanic and non-Hispanic patients, there was still variability in ultrasound scans performed and antiemetics ordered, despite similarities in reported abdominal pain, nausea, and vomiting. Prospective and/or qualitative studies may be needed to clarify underlying reasons for these differences.
Publisher
American Academy of Pediatrics (AAP)
Subject
Pediatrics,General Medicine,Pediatrics, Perinatology and Child Health
Reference29 articles.
1. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of diarrhea in 195 countries: a systematic analysis for the Global Burden of Disease Study 2016;GBD 2016 Diarrhoeal Disease Collaborators;Lancet Infect Dis,2018
2. Lucado J, Mohamoud S, Zhao L, Elixhauser A. Agency for Healthcare Research and Quality. Infectious enteritis and foodborne illness in the United States, 2010. Available at: www.hcup-us.ahrq.gov/reports/statbriefs/sb150.pdf. Accessed October 15, 2020
3. Acute gastroenteritis in children of the world: what needs to be done?;Guarino;J Pediatr Gastroenterol Nutr,2020
4. 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea;Shane;Clin Infect Dis,2017