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

TY - JOUR

T1 - Predictors of mortality among hospitalized children with severe acute malnutrition

T2 - a prospective study from Uganda

AU - Nabukeera-Barungi, Nicolette

AU - Grenov, Benedikte

AU - Lanyero, Betty

AU - Namusoke, Hanifa

AU - Mupere, Ezekiel

AU - Christensen, Vibeke Brix

AU - Michaelsen, Kim F.

AU - Mølgaard, Christian

AU - Rytter, Maren Johanne Heilskov

AU - Friis, Henrik

N1 - CURIS 2018 NEXS 181

PY - 2018/7/1

Y1 - 2018/7/1

N2 - 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.

AB - 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.

U2 - 10.1038/s41390-018-0016-x

DO - 10.1038/s41390-018-0016-x

M3 - Journal article

C2 - 29795207

SN - 0031-3998

VL - 84

SP - 92

EP - 98

JO - Pediatric Research

JF - Pediatric Research

ER -