Evaluation of the modes of rehydration of infants hospitalized with acute gastroenteritis. Efficiency of a permanent pediatrician using a short-stay observation unit

Diarrheal diseases account for 10% of hospitalizations in infants, and larg e differences in rates of hospitalization have been reported. Objective. - To analyze hospital treatment of infants with acute gastroente ritis, especially the variations in modes of rehydration, hospitalization r ates and lengths of stay, related to paediatrician permanency with a short- stay observation unit at their disposal. Methods. - This prospective multicentric study during two rotavirus epidemi c periods included 1,187 infants (mean age 10 +/- 6 months) with acute gast roenteritis resulting or not in dehydration. During the first period, 12 vo lunteer hospitals were included. During the second period, we compared six (among the 12) hospitals where infants were admitted in emergency care or p ediatric units without pediatric 24-h permanency, with a pediatric emergenc y care unit having pediatric permanency with a short-stay observation unit. Results. - During the first period, 32% were dehydrated and 6% had hypovole mic shock on admission. The hospitalization rate was 81%. Only 19% of dehyd rated infants had exclusively oral rehydration, and 19% of normohydrated in fants had intravenous rehydration. During the second period, the hospitaliz ation rate was 42% in the pediatric emergency care unit (28% in the short-s tay unit and 14% in hospitalization units) versus 77% in the six hospitals. In the pediatric emergency care unit as compared to the six hospitals, the re were a reduction of 65% of hospitalization days, 58% of intravenous acce sses, and 66% of laboratory tests. Conclusion. - Our findings suggest that a paediatric permanency with a shor t-stay observation unit at their disposal improves quality of treatment and is cost-effective. (C) 2001 Editions scientifiques et medicales Elsevier S AS.