Risk Factors for Mortality in Severely Ill Children Admitted to a Tertiary Referral Hospital in Malawi
| Autor: | Chikondi H. A. Phiri, Helena Hildenwall, Tim Baker, Fatsani Ngwalangwa, Josephine Langton, Queen Dube |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Malawi Adolescent Severe Acute Malnutrition Vital signs Tertiary referral hospital Intensive Care Units Pediatric Severity of Illness Index Tertiary Care Centers Risk Factors Virology Severity of illness medicine Odds Ratio Humans Hospital Mortality Prospective Studies Prospective cohort study Child business.industry Infant Newborn Infant Odds ratio Articles medicine.disease Malnutrition Infectious Diseases Logistic Models Child Preschool Parasitology Female business Emergency Service Hospital Cohort study |
| Zdroj: | The American Journal of Tropical Medicine and Hygiene |
| ISSN: | 1476-1645 |
| Popis: | In low-resource settings, many children are severely ill at arrival to hospital. The risk factors for mortality among such ill children are not well-known. Understanding which of these patients are at the highest risk could assist in the allocation of limited resources to where they are most needed. A cohort study of severely ill children treated in the resuscitation room of the pediatric emergency department at Queen Elizabeth Central Hospital in Malawi was conducted over a 6-month period in 2017. Data on signs and symptoms, vital signs, blood glucose levels, and nutritional status were collected and linked with in-hospital mortality data. The factors associated with in-hospital mortality were analyzed using multivariable logistic regression. Data for 1,359 patients were analyzed and 118 (8.7%) patients died. The following factors were associated with mortality: presence of any severely deranged vital sign, unadjusted odds ratio (UOR) 2.6 (95% CI 1.7–4.0) and adjusted odds ratio (AOR) 3.2 (95% CI 2.0–5.0); severe dehydration, UOR 2.6 (1.4–5.1) and AOR 2.8 (1.3–6.0); hypoglycemia glycemia (< 5 mmol/L), UOR 3.6 (2.2–5.8) and AOR 2.7 (1.6–4.7); and severe acute malnutrition, UOR 5.8 (3.5–9.6) and AOR 5.7 (3.3–10.0). This study suggests that among severely sick children, increased attention should be given to those with hypo/low glycemia, deranged vital signs, malnutrition, and severe dehydration to avert mortality among these high-risk patients. |
| Databáze: | OpenAIRE |
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