Lack of Association of Household Income and Acute Gastroenteritis Disease Severity in Young Children: A Cohort Study
Abstract
Objective: To determine if low household income is associated with disease severity following emergency department (ED) discharge in children with acute gastroenteritis (AGE). Methods: We conducted a secondary analysis employing data collected in ten US-based tertiary-care, pediatric EDs between 2014 and 2017. Participants were aged 3–48 months and presented for care due to AGE. Income status was defined based on 1)home ZIP Code median annual home income and 2)percentage of home ZIP Code households below the poverty threshold. The primary outcome was moderate-to-severe AGE, defined by a post-ED visit Modified Vesikari Scale (MVS) score ≥9. Secondary outcomes included in-person revisits, revisits with intravenous rehydration, hospitalization, and etiologic pathogens. Results: 943 (97%) participants with a median age of 17 months (IQR 10, 28) completed follow-up. Post-ED visit MVS scores were lower for the lowest household income group (adjusted: −0.59; 95%CI: −1.09, −0.08). Odds of experiencing an MVS score ≥9 did not differ between groups (adjusted OR: 0.91; 95%CI: 0.53, 1.56). No difference in the post-ED visit MVS score or the proportion of participants with scores ≥9 were observed using the national poverty threshold definition. For both income definitions, there were no differences in terms of revisits following discharge, hospitalizations and intravenous rehydration. Bacterial enteropathogens were more commonly identified in the lowest socio-economic group using both…
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Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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