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Predicting therapeutic efficacy of oral rehydration salts in children with vasovagal syncope
OBJECTIVE: This 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 METHODS: Children diagnosed with VVS and treated with ORS for a median of 3 months at the Peking Un...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10133722/ https://www.ncbi.nlm.nih.gov/pubmed/37124188 http://dx.doi.org/10.3389/fped.2023.1164304 |
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author | Du, Xiaojuan Tao, Chunyan Li, Xueying Du, Junbao Liao, Ying Jin, Hongfang |
author_facet | Du, Xiaojuan Tao, Chunyan Li, Xueying Du, Junbao Liao, Ying Jin, Hongfang |
author_sort | Du, Xiaojuan |
collection | PubMed |
description | OBJECTIVE: This 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 METHODS: Children 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. RESULTS: Totally 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. CONCLUSION: Hemoglobin combined with BMI was useful for predicting the therapeutic efficacy of ORS in children with VVS. |
format | Online Article Text |
id | pubmed-10133722 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-101337222023-04-28 Predicting therapeutic efficacy of oral rehydration salts in children with vasovagal syncope Du, Xiaojuan Tao, Chunyan Li, Xueying Du, Junbao Liao, Ying Jin, Hongfang Front Pediatr Pediatrics OBJECTIVE: This 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 METHODS: Children 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. RESULTS: Totally 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. CONCLUSION: Hemoglobin combined with BMI was useful for predicting the therapeutic efficacy of ORS in children with VVS. Frontiers Media S.A. 2023-04-13 /pmc/articles/PMC10133722/ /pubmed/37124188 http://dx.doi.org/10.3389/fped.2023.1164304 Text en © 2023 Du, Tao, Li, Du, Liao and Jin. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Du, Xiaojuan Tao, Chunyan Li, Xueying Du, Junbao Liao, Ying Jin, Hongfang Predicting therapeutic efficacy of oral rehydration salts in children with vasovagal syncope |
title | Predicting therapeutic efficacy of oral rehydration salts in children with vasovagal syncope |
title_full | Predicting therapeutic efficacy of oral rehydration salts in children with vasovagal syncope |
title_fullStr | Predicting therapeutic efficacy of oral rehydration salts in children with vasovagal syncope |
title_full_unstemmed | Predicting therapeutic efficacy of oral rehydration salts in children with vasovagal syncope |
title_short | Predicting therapeutic efficacy of oral rehydration salts in children with vasovagal syncope |
title_sort | predicting therapeutic efficacy of oral rehydration salts in children with vasovagal syncope |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10133722/ https://www.ncbi.nlm.nih.gov/pubmed/37124188 http://dx.doi.org/10.3389/fped.2023.1164304 |
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