Predictability of prognosis of infantile hypernatremic dehydration: a prospective cohort study.

BACKGROUND

Infantile hypernatremic dehydration (IHD) is a life-threatening disease with potential cerebral adverse effects.

PURPOSE: This study was conducted to evaluate the prognosis of IHD.

METHODS/SEARCH STRATEGY: Using convenience sampling 183 term infants with IHD (Na+ > 150 mg/dl) were enrolled in a cohort study with 36 months follow-up during 2007-2017. A researcher-made questionnaire was used for data collection. Follow-up visits were performed using the Denver Developmental Screening II test after discharging from hospital. The t-test, chi-square test, regression models, and receiver-operating characteristic curve were performed for data analysis.

FINDINGS/

RESULTS

17.5% of neonates were diagnosed with abnormal outcomes. Postpartum breast growth, breastfeeding frequency and duration, convulsion, consciousness, urination frequency, urea, Cr, sodium and brain CT scan (p = .000) showed significant differences (p < .05) between the infants with normal and abnormal outcomes. Combination of the above variables had a high predictive power (98.6%) for determining the unfavorable prognosis in infants with IHD.

IMPLICATIONS FOR PRACTICE: Sodium, urea and creatinine are high-sensitive/specific determinants of IHD prognosis. Combination of some risk factors is highly predictive for unfavorable prognosis of IHD.

IMPLICATIONS FOR RESEARCH: Combination of variables such as sodium, urea, creatinine, lethargy, state of fontanels, convulsion, loss of consciousness, state of the breast during postpartum, inverted nipple and brain CT scan has a high predictive power in the determination of unfavorable prognosis in IHD.