Early Predictors of Complicated Acute Gastroenteritis in Children: The Role of Inflammatory and Hematological Biomarkers
Keywords:
Acute gastroenteritis, Children, C-reactive protein, Neutrophil-to-lymphocyte ratio, DehydrationAbstract
Acute gastroenteritis (AGE) is a frequent source of morbidity in children, and can be a self-limited illness or result in significant dehydration, electrolyte abnormalities, and systemic complications. Clinically important to identify children who are at risk of complicated disease in a timely manner. Aim of this study to assess the predictive capacity of some inflammatory-, hematological- and biochemical markers for early recognition of complicated AGE in children. A prospective analytical study was done from April 2024 to April 2025 in children aged 6 months to 5 years with AGE (n = 120). There were an equal number of uncomplicated (60) and complicated (60) AGE groups. Assessment of clinical characteristics, complete blood count, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), serum sodium, potassium, urea, creatinine and stool examination results were done. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed. The results showed that children with complicated AGE had significantly higher WBC, neutrophil, NLR, PLR, CRP, ESR, urea and creatinine levels as well as decreased levels of lymphocytes, sodium and potassium levels than those with uncomplicated AGE (P<0.05). The NLR, the CRP level, leukocytosis, ESR, hyponatremia and urea level were independently associated with complicated AGE. The NLR and CRP had the highest discriminatory values with AUCs of 0.88 and 0.89, respectively. Although there is no clear consensus, inflammatory and hematological biomarkers (CRP and NLR) along with routine clinical and biochemical parameters may help identify children early who are at higher risk of complicated AGE and facilitate timely clinical management.
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