Predictors of mortality among hospitalized children with severe acute malnutrition: a prospective study from Uganda

Background We determined the predictors of mortality among children admitted with severe acute malnutrition (SAM). Methods This was a prospective study nested in a randomized trial among 6–59-month-old children admitted with SAM. Socio-demographic and medical history data were collected using questi...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Pediatric research 2018-07, Vol.84 (1), p.92-98
Hauptverfasser: Nabukeera-Barungi, Nicolette, Grenov, Benedikte, Lanyero, Betty, Namusoke, Hanifa, Mupere, Ezekiel, Christensen, Vibeke Brix, Michaelsen, Kim F., Mølgaard, Christian, Rytter, Maren Johanne, Friis, Henrik
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:Background We determined the predictors of mortality among children admitted with severe acute malnutrition (SAM). Methods This was a prospective study nested in a randomized trial among 6–59-month-old children admitted with SAM. Socio-demographic and medical history data were collected using questionnaires and clinical examination, anthropometry and laboratory tests were performed. They were monitored daily until discharge or death during hospitalization while receiving care according to national guidelines. Predictors of death were assessed using Cox regression. Results Of 400 children, 9.8% ( n  = 39) died during hospitalization. Predictors of mortality included diarrhoea at admission [hazard ratio [HR] 2.19, 95% confidence interval (CI): 1.06; 4.51], lack of appetite [HR 4.50, 95% CI: 1.76; 11.50], suspected sepsis [HR 2.23, 95% CI: 1.18; 4.24] and skin ulcers [HR 4.23, 95% CI: 1.26; 4.17]. Chest indrawing [HR 5.0, 95% CI: 1.53; 16.3], oxygen saturation below 94% [HR 3.92, 95% CI: 1.42; 10.83] and confirmed HIV infection [HR 3.62, 95% CI: 1.69; 7.77] also predicted higher mortality. Conclusion Infections were major contributors to mortality. This underscores the need for improved prevention and management of these infections among children with severe malnutrition.
ISSN:0031-3998
1530-0447
DOI:10.1038/s41390-018-0016-x