Abstract
Background: To assess the reliability of complete blood count (CBC) in the capillary blood of children with acute gastroenteritis (AGE), with a focus on leukocytes.Methods: This was a retrospective cross-sectional study. Complete blood count was compared between the capillary and venous blood in children admitted to a pediatric gastroenterology department with primary diagnosis of AGE (ICD-10 A09, A08.0, A08.2). Capillary blood was obtained in the emergency room and venous blood was sampled in the ward shortly thereafter during peripheral intravenous line placement.Results: One hundred and forty children were included. The mean (±SD) age and weight of patients were 3.0 ± 2.9 years and 16 ± 9 kg; 26% had leukocytosis. The mean difference between obtaining results of capillary and venous blood tests was 2 ± 1 h. Area under the receiver operating characteristic curve (AUC) for the identification of leukocytosis using the capillary blood was 0.98 (95% CI 0.96–1.0). The sensitivity and specificity were 86 and 98%, respectively (accuracy 95%). The positive and negative predictive values were 94 and 95%, respectively. The intraclass correlation coefficient revealed high concordance between capillary and venous CBC measurements (leukocyte count 0.94, hemoglobin 0.88, erythrocyte count 0.77, hematocrit 0.79, platelet count 0.90). Matched pairs comparisons revealed marginally higher erythrocytes (difference of medians: 0.2 T/L), hemoglobin (0.3 g/dL), hematocrit (1.0%), and platelets (9 G/L) in the capillary blood.Conclusion: Capillary CBC is useful in detecting leukocytosis in children with AGE.
Highlights
Acute gastroenteritis (AGE) is defined by ESPGHAN as a decrease in the consistency of stools and/or an increase in their frequency, with or without fever or vomiting
Dehydration, small fingers and the poor capillary network may cause technical difficulties in capillary blood sampling among pediatric patients and reduce diagnostic accuracy [2]
The inclusion criteria comprised: (a) a primary diagnosis of AGE, (b) hematological and electrolyte measurements in the capillary blood in the emergency room and in the venous blood, which were obtained during venipuncture on admission to the hospital, and (c) the time between receiving the results of the two measurements shorter than 4 h
Summary
Acute gastroenteritis (AGE) is defined by ESPGHAN as a decrease in the consistency of stools and/or an increase in their frequency, with or without fever or vomiting. AGE remains a leading cause of pediatric hospitalizations, especially in children below 3 years of age [1]. The tests may include electrolyte levels, blood gas (pH, bicarbonates, base excess) and a complete blood count (CBC), which helps to rule out more severe conditions. The Capillary CBC in Gastroenteritis collection of capillary blood is less invasive for the patient than venous blood sampling. Dehydration, small fingers and the poor capillary network may cause technical difficulties in capillary blood sampling among pediatric patients and reduce diagnostic accuracy [2]. To assess the reliability of complete blood count (CBC) in the capillary blood of children with acute gastroenteritis (AGE), with a focus on leukocytes
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