Abstract
Background: Acute diarrhea is a worldwide health concern with a high mortality rate among children under five. Dehydration, a potentially fatal consequence of this illness, must be promptly identified. A scoring system is necessary to predict the degree of dehydration. Objectives: This study aims to identify risk factors and develop a scoring system with an appropriate cutoff to estimate the likelihood of dehydration in children with acute diarrhea. Methods: In this case-control study, the patient group comprised 34 children with acute diarrhea and dehydration, while the control group included 137 children with acute diarrhea without dehydration, admitted to the Gastroenterology Department of Can Tho Children's Hospital, Can Tho city, Vietnam, from November 2022 to October 2023. Results: Acute diarrhea with dehydration was associated with the following factors: Fever (OR 1.802, 95% CI 1.703 - 3.024, P = 0.026), frequency of diarrhea per day (OR 1.744, 95% CI 1.432 - 2.125, P < 0.001), frequency of vomiting per day (OR 1.242, 95% CI 1.102 - 1.399, P < 0.001), and weight-for-age > +2SD (OR 3.293, 95% CI 1.151 - 9.422, P = 0.026). Based on these four parameters and an area under the ROC curve of 0.889, a new scoring system known as the KVAD (K: Kelvin, V: Vomit, A: Avoirdupois, D: Diarrhea) score has been developed. A score of 21 was determined as the optimal cutoff point for identifying dehydration in children with acute diarrhea, with a sensitivity of 79.4% and specificity of 85.4%. Conclusions: The KVAD score represents the initial step in developing an effective and reliable screening tool for estimating the risk of dehydration in children with acute diarrhea.