Post-hospital mortality in children aged 2-12 years in Tanzania: A prospective cohort study
Autor: | Adolfine Hokororo, Neema Chami, Luke R. Smart, Neema Kayange, Duncan K. Hau, Robert N. Peck, Aynsley Duncan |
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Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
Male
Time Factors Physiology lcsh:Medicine Urine Tanzania Pediatrics Biochemistry Families 0302 clinical medicine Risk Factors Medicine and Health Sciences Public and Occupational Health 030212 general & internal medicine Hospital Mortality Prospective Studies Prospective cohort study Child lcsh:Science Children 2. Zero hunger Multidisciplinary Mortality rate Hazard ratio Age Factors Child Health Hematology Patient Discharge 3. Good health Body Fluids Genetic Diseases Child Preschool Child Mortality Female Anatomy Research Article medicine.medical_specialty Death Rates 030231 tropical medicine 03 medical and health sciences Population Metrics Autosomal Recessive Diseases Internal medicine medicine Humans Hemoglobin Nutrition Clinical Genetics Sickle Cell Disease Population Biology business.industry Septic shock Proportional hazards model Hospitals Public Malnutrition lcsh:R Glasgow Coma Scale Biology and Life Sciences Proteins medicine.disease Child mortality Hemoglobinopathies Age Groups People and Places Population Groupings lcsh:Q business Follow-Up Studies |
Zdroj: | PLoS ONE, Vol 13, Iss 8, p e0202334 (2018) PLoS ONE |
ISSN: | 1932-6203 |
Popis: | Background Sub-Saharan Africa has the highest rates of child mortality worldwide. Little is known about post-hospital outcomes after an index hospitalization for older children. We determined 12-month post-hospital mortality rate and identified factors associated with higher mortality. Methods In this prospective cohort study, we enrolled children 2–12 years of age admitted to the pediatric wards of two public hospitals in northwestern Tanzania. Participants or proxies were contacted at 3, 6 and 12 months post-hospitalization. The primary outcome measured was mortality. Factors associated with mortality were determined using Cox regression analysis. Results A total of 506 participants were enrolled. In-hospital mortality rate was 7.7% (39/506). Of the 467 participants discharged, the post-hospital mortality rate was 10.1% (47/467). Sickle cell disease (Hazard Ratio (HR) 3.32, 95% CI 1.44–7.68), severe malnutrition (HR 3.19, 95% CI 1.18–8.57), neurologic diseases (HR 3.51, 95% CI 1.35–9.11), heart disease (HR 7.11, 95% CI, 2.89–17.51), cancer (HR 11.79, 95% CI 4.95–28.03), and septic shock (HR 4.64, 95% CI 1.42–15.08) had higher association with mortality compared to other diagnoses. The risk factors significantly associated with mortality included older age (HR 1.01, 95% CI 1.00–1.08), lower hemoglobin level (HR 0.83, 95% CI 0.76–0.90), lower Glasgow Coma Scale (HR 0.66, 95% CI 0.59–0.74), history of decreased urine output (HR 2.87, 95% CI 1.49–5.53), higher respiratory rate (HR 1.02, 95% CI 1.00–1.03), estimated glomerular filtration rate less than 60 ml/min/1.73m2 (binary) (HR 1.84, 95% CI 1.10–3.10), and lower oxygen saturation (HR 0.96, 95% CI 0.92–0.99). Conclusions Post-hospital mortality is disturbingly high among children 2–12 years of age in Tanzania. Post-hospital interventions are urgently needed especially for older children with chronic illnesses. |
Databáze: | OpenAIRE |
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