To explore the predictive value of electrolyte imbalance and abnormal coagulation function for the failure of fluid replacement therapy in children with rotavirus enteritis (RE).

The clinical data of 268 children with RE who underwent fluid replacement treatment in Suzhou Wujiang District Children's Hospital from February 2021 to February 2025 were selected. According to the outcome of fluid replacement treatment, they were divided into the successful treatment group (n=207) and the failed treatment group (n=61). The levels of electrolytes and coagulation function indicators of the two groups of children at admission were compared. Spearman correlation analysis was conducted to investigate the correlation between electrolyte imbalance, coagulation function and the failure of fluid replacement therapy in children with RE. Multivariate Logistic regression analysis was used to screen for independent risk factors of fluid replacement therapy failure, and the predictive efficacy was evaluated through the receiver operating characteristic (ROC) curve.

The levels of C-reactive protein (CRP) and procalcitonin in the treatment failure group were higher than those in the treatment success group, while the levels of blood sodium, blood potassium and blood calcium were all lower than those in the treatment success group, with statistically significant differences (all P<0.05). The prothrombin time (PT) and activated partial thromboplastin time (APTT) values in the treatment failure group were both higher than those in the treatment success group, while the fibrinogen (FIB) value was lower than that in the treatment success group, with statistically significant differences (all P<0.05). Spearman correlation showed that the levels of blood sodium, blood potassium, blood calcium and FIB were negatively correlated with the failure of fluid replacement treatment in children with RE, while the levels of PT and APTT were positively correlated with the failure of fluid replacement treatment in children with RE (all P<0.05). Binary logistic showed that high CRP, low blood sodium, low blood potassium, high APTT, and low FIB levels were independent risk factors for the failure of fluid replacement treatment in children with RE (all P<0.05). ROC showed that CRP, blood sodium, blood potassium, APTT, FIB and combined detection all demonstrated certain predictive values for the failure of fluid replacement therapy, with AUCs of 0.767, 0.780, 0.751, 0.764, 0.731 and 0.941, respectively. The sensitivities were 0.590, 0.449, 0.643, 0.623, 0.483, and 0.885 respectively, and the specificities were 0.836, 0.967, 0.787, 0.787, 0.918, and 0.894. Moreover, the ROC AUC of the combined detection was higher than that of each individual independent prediction (all P<0.05).

CRP, blood sodium, blood potassium, APTT, and FIB are independent risk factors for the failure of fluid replacement therapy in children with RE, and the combined detection of the above indicators can significantly improve the predictive efficacy for treatment failure.