Systematic Review and Meta-Analysis of Risk Factors for Dehydration and the Development of a Predictive Scoring System

Abstract

Background: Dehydration is a prevalent and potentially serious condition, particularly affecting vulnerable populations such as children and older adults. Prompt recognition and intervention are critical for preventing associated complications.

Methods: A systematic review and meta-analysis were conducted, registered in PROSPERO (CRD42024594780), to identify key clinical and demographic risk factors associated with dehydration. A comprehensive search of PubMed, Scopus, and the Cochrane Library was performed for studies published between 2000 and 2024. The risk of bias in included studies was assessed using the Newcastle-Ottawa Scale and the Cochrane Risk-of-Bias (RoB) tool. Ten studies met the inclusion criteria for quantitative synthesis. Based on pooled diagnostic metrics, a preliminary scoring tool was developed for dehydration risk stratification.

Results: The pooled sensitivity and specificity of common clinical signs, such as thirst, dry mouth, and dark urine, were 85% (95% CI: 80-90%) and 70% (95% CI: 65-75%), respectively. The positive predictive value (PPV) was 75%, and the negative predictive value (NPV) was 80%. Pediatric subgroup analysis yielded the most robust data, while data for adult and elderly populations were limited. A conceptual risk scoring system was proposed based on relative diagnostic utility, though it has not yet been externally validated.

Conclusions: Simple clinical signs demonstrate reasonable diagnostic accuracy for identifying individuals at risk of dehydration. The proposed scoring system offers a promising, evidence-informed framework for early risk assessment but requires further validation in prospective studies before integration into clinical practice.