Study objective

This study aimed to explore oral ondansetron usage and impact on outcomes in clinical practice.

Methods

This observational study was a planned secondary analysis of 2 trials conducted in 10 US and 6 Canadian institutions between 2014 and 2017. Children 3 to 48 months old with gastroenteritis and ≥3 episodes of vomiting in the 24 hours preceding emergency department (ED) presentation were included. Oral ondansetron was administered at the discretion of the provider. The principal outcomes were intravenous fluid administration and hospitalization at the index visit and during the subsequent 72 hours and diarrhea and vomiting frequency during the 24 hours following the ED visit.

Results

In total, 794 children were included. The median age was 16.0 months (interquartile range 10.0 to 26.0), and 50.1% (398/794) received oral ondansetron. In propensity-adjusted analysis (n=528), children administered oral ondansetron were less likely to receive intravenous fluids at the index visit (adjusted odds ratio [aOR] 0.50; 95% confidence interval [CI] 0.29 to 0.88). There were no differences in the frequencies of intravenous fluid administration within the first 72 hours (aOR 0.65; 95% CI 0.39 to 1.10) or hospitalization at the index visit (aOR 0.31; 95% CI 0.09 to 1.10) or the subsequent 72 hours (aOR 0.52; 95% CI 0.21 to 1.28). Episodes of vomiting (aRR 0.86; 95% CI 0.63 to 1.19) and diarrhea (aRR 1.11; 95% CI 0.93 to 1.32) during the 24 hours following ED discharge also did not differ.

Conclusion

Among preschool-aged children with gastroenteritis seeking ED care, oral ondansetron administration was associated with a reduction in index ED visit intravenous fluid administration; it was not associated with intravenous fluids administered within 72 hours, hospitalization, or vomiting and diarrhea in the 24 hours following discharge.

中文翻译：

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因急性胃肠炎寻求急诊科护理的儿童口服昂丹司琼：患者水平的倾向匹配分析

学习目标

本研究旨在探讨口服昂丹司琼的使用及其对临床实践结果的影响。

方法

这项观察性研究是对 2014 年至 2017 年间在美国 10 家机构和加拿大 6 家机构进行的 2 项试验的计划二次分析。3 至 48 个月大的患有胃肠炎且在急诊科 (ED) 就诊前 24 小时内呕吐 ≥ 3 次的儿童被纳入包括。口服昂丹司琼由提供者自行决定。主要结果是首次就诊时和随后 72 小时内的静脉输液和住院治疗，以及急诊就诊后 24 小时内腹泻和呕吐的频率。

结果

总共包括 794 名儿童。中位年龄为 16.0 个月（四分位间距 10.0 至 26.0），50.1% (398/794) 接受口服昂丹司琼。在倾向调整分析 (n=528) 中，给予口服昂丹司琼的儿童在初次就诊时接受静脉输液的可能性较小（调整后的比值比 [aOR] 0.50；95% 置信区间 [CI] 0.29 至 0.88）。前 72 小时内静脉输液频率（aOR 0.65；95% CI 0.39 至 1.10）或首次就诊时住院（aOR 0.31；95% CI 0.09 至 1.10）或随后 72 小时内的频率没有差异（ aOR 0.52；95% CI 0.21 至 1.28）。急诊室出院后 24 小时内呕吐（aRR 0.86；95% CI 0.63 至 1.19）和腹泻（aRR 1.11；95% CI 0.93 至 1.32）的发作也没有差异。

结论

在寻求急诊治疗的患有胃肠炎的学龄前儿童中，口服昂丹司琼与急诊就诊静脉输液次数减少相关；它与 72 小时内静脉输液、住院或出院后 24 小时内呕吐和腹泻无关。