| General appearance | Normal Thirsty, restless, or lethargic but irritable when touched Drowsy, limp, cold, or sweaty; comatose or not arousable |
| Eyes | Normal Slightly sunken Very sunken |
| Mucous membranes (tongue) | Moist Sticky Dry |
| Tears | Normal tears Decreased tears Absent tears |
The Clinical Dehydration Scale (CDS) was developed by Goldman RD, in 2004.
This study included 137 children, ages 1-36 mos, seen in the emergency department for acute gastroenteritis.
The children were weighed and scored for 12 clinical signs. Following rehydration, they were weighed and rescored.
The final Clinical Dehydration Scale (CDS) consists of four clinical characteristics:
The validity of the CDS was 0.36-0.57, where as the reliability was found to be 0.77. The Authors concluded that this scale can be used by clinicians and researchers, as an alternative to scales developed ad hoc.
The CDS was validated by the same authors in 2008. This study included a total of 205 children in the age group age of 1 month to 5 years, seen at a Canadian tertiary care ED.
The main outcome measures were length of stay, proportion of children receiving intravenous fluid rehydration, and proportions of children with abnormal serum pH values or bicarbonate levels. At the end of the study, it was found that the 3 dehydration categories were positively associated with the length of stay, and the proportions of the children who received IV rehydration. Though the severity categories demonstrated a positive association with the proportions of children with abnormal serum pH values or bicarbonate levels, this association was not statistically significant.
The Authors concluded that the Clinical Dehydration Scale (CDS) and the 3 severity categories were valid for a prospectively enrolled cohort study. The scoring system was valuable in predicting a longer length of stay and the need for IV rehydration for children with acute gastroenteritis.
The components of the CDS along with the scoring are as follows.
| Characteristic | Score=0 | Score = 1 | Score = 2 |
|---|---|---|---|
| General appearance | Normal | Thirsty, restless, or lethargic but irritable when touched | Drowsy, limp, cold, or sweaty; comatose or not arousable |
| Eyes | Normal | Slightly sunken | Very sunken |
| Mucous membranes(tongue) | Moist | Sticky | Dry |
| Tears | Tears | Decreased tears | Absent tears |
The points for these 4 items are summed to receive a score 0-8.
The interpretation is:
References:
Ran D. Goldman et al. Development of a clinical dehydration scale for use in children between 1 and 36 months of age. J Pediatr. 2004 Aug; 145(2): 201-7.
Ran D. Goldman et al. Validation of the Clinical Dehydration Scale for Children With Acute Gastroenteritis. Pediatrics 2008 Sep; 122(3); 545-549