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Time-series analysis of ondansetron use in pediatric gastroenteritis.
J Pediatr Gastroenterol Nutr. 2012 Mar; 54(3):381-6.JP

Abstract

OBJECTIVE

Emergency department use of ondansetron in children with gastroenteritis is increasing; however, its effect on clinical outcomes is unknown. We aimed to determine whether increasing ondansetron usage is associated with improved outcomes in children with gastroenteritis.

METHODS

A retrospective cohort study was conducted at The Hospital for Sick Children, Toronto, Canada. Eligible children included those younger than 18 years old with gastroenteritis who presented to an emergency department between 2003 and 2008. There were 22,125 potentially eligible visits; 20% were selected at random for chart review. The primary outcome measure, the intravenous rehydration rate, was evaluated using an interrupted time-series analysis with segmented logistic regression. Secondary outcomes included emergency department revisits, hospitalization, and length of stay.

RESULTS

A total of 3508 patient visits were included in the final analysis. During the study period, there was a significant reduction in intravenous rehydration usage (27%-13%; P < 0.001) and an increase in ondansetron administration (1%-18%; P < 0.001). Time-series analysis demonstrated a level break (P = 0.03) following the introduction of ondansetron. The mean length of stay for children declined from 8.6 ± 3.4 to 5.9 ± 2.8 hours, P = 0.03. During the week following the index visit, there was a reduction in return visits (18%-13%; P = 0.008) and need for intravenous rehydration (7%-4%; P = 0.02).

CONCLUSIONS

Ondansetron use has increased significantly and is associated with reductions in the use of intravenous rehydration, emergency department revisits, and length of stay. The selective use of ondansetron is associated with improved clinical outcomes.

Authors+Show Affiliations

The Hospital for Sick Children, The University of Toronto, Toronto, Canada. stephen.freedman@sickkids.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22167016

Citation

Freedman, Stephen B., et al. "Time-series Analysis of Ondansetron Use in Pediatric Gastroenteritis." Journal of Pediatric Gastroenterology and Nutrition, vol. 54, no. 3, 2012, pp. 381-6.
Freedman SB, Tung C, Cho D, et al. Time-series analysis of ondansetron use in pediatric gastroenteritis. J Pediatr Gastroenterol Nutr. 2012;54(3):381-6.
Freedman, S. B., Tung, C., Cho, D., Rumantir, M., & Chan, K. J. (2012). Time-series analysis of ondansetron use in pediatric gastroenteritis. Journal of Pediatric Gastroenterology and Nutrition, 54(3), 381-6. https://doi.org/10.1097/MPG.0b013e31822ecaac
Freedman SB, et al. Time-series Analysis of Ondansetron Use in Pediatric Gastroenteritis. J Pediatr Gastroenterol Nutr. 2012;54(3):381-6. PubMed PMID: 22167016.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Time-series analysis of ondansetron use in pediatric gastroenteritis. AU - Freedman,Stephen B, AU - Tung,Connie, AU - Cho,Dennis, AU - Rumantir,Maggie, AU - Chan,Kevin J, PY - 2011/12/15/entrez PY - 2011/12/15/pubmed PY - 2012/9/6/medline SP - 381 EP - 6 JF - Journal of pediatric gastroenterology and nutrition JO - J Pediatr Gastroenterol Nutr VL - 54 IS - 3 N2 - OBJECTIVE: Emergency department use of ondansetron in children with gastroenteritis is increasing; however, its effect on clinical outcomes is unknown. We aimed to determine whether increasing ondansetron usage is associated with improved outcomes in children with gastroenteritis. METHODS: A retrospective cohort study was conducted at The Hospital for Sick Children, Toronto, Canada. Eligible children included those younger than 18 years old with gastroenteritis who presented to an emergency department between 2003 and 2008. There were 22,125 potentially eligible visits; 20% were selected at random for chart review. The primary outcome measure, the intravenous rehydration rate, was evaluated using an interrupted time-series analysis with segmented logistic regression. Secondary outcomes included emergency department revisits, hospitalization, and length of stay. RESULTS: A total of 3508 patient visits were included in the final analysis. During the study period, there was a significant reduction in intravenous rehydration usage (27%-13%; P < 0.001) and an increase in ondansetron administration (1%-18%; P < 0.001). Time-series analysis demonstrated a level break (P = 0.03) following the introduction of ondansetron. The mean length of stay for children declined from 8.6 ± 3.4 to 5.9 ± 2.8 hours, P = 0.03. During the week following the index visit, there was a reduction in return visits (18%-13%; P = 0.008) and need for intravenous rehydration (7%-4%; P = 0.02). CONCLUSIONS: Ondansetron use has increased significantly and is associated with reductions in the use of intravenous rehydration, emergency department revisits, and length of stay. The selective use of ondansetron is associated with improved clinical outcomes. SN - 1536-4801 UR - https://www.unboundmedicine.com/medline/citation/22167016/Time_series_analysis_of_ondansetron_use_in_pediatric_gastroenteritis_ L2 - https://doi.org/10.1097/MPG.0b013e31822ecaac DB - PRIME DP - Unbound Medicine ER -