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.