Levine et al reported the Pediatric Acute Gastroenteritis Risk (PAGER) score for evaluating an infant or small child with gastroenteritis. This can help to identify a patient who will have a moderate-to-severe clinical course. The authors are from multiple institutions in the United States, Canada, and England.
Patient selection: infant or small child 3 to 48 months of age with acute gastroenteritis
Parameters:
(1) age in months
(2) number of vomiting episodes in the past 24 hours
(3) dehydration status
(4) intravenous fluids administered at index ED visit
(5) prior ED visit(s)
Parameter
Finding
Points
age group
3 to 12 months
2
> 12 months
0
number of vomiting episodes
0
0
1 to 4
1
>= 5
3
dehydration status
none
0
mild or moderate
1
severe
3
IV fluids
no
0
yes
1
prior ED visit(s)
no
0
yes
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
Total Score
Risk Category
Moderate or Severe
0 to 4
low
7 to 26%
5 to 7
medium
33 to 50%
8 to 10
high
60 to 75%
Performance:
• The area under the ROC curve is 0.68.
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