Risk factors for mortality and management of children with complicated severe acute malnutrition at a tertiary referral hospital in Malawi.
Malawi
Mortality
clinical risk factors
quality of care
severe acute malnutrition
Journal
Paediatrics and international child health
ISSN: 2046-9055
Titre abrégé: Paediatr Int Child Health
Pays: England
ID NLM: 101582666
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
pubmed:
4
4
2020
medline:
28
8
2021
entrez:
4
4
2020
Statut:
ppublish
Résumé
Severe acute malnutrition (SAM) is a major cause of childhood mortality in resource-limited settings. The relationship between clinical factors and adherence to the 'WHO 10 Steps' and mortality in children with SAM is not fully understood. Data from an ongoing prospective observational cohort study assessing admission characteristics, management patterns and clinical outcome in children aged 6-36 months admitted to a tertiary hospital in Malawi from September 2018 to September 2019 were analysed. Data clerks independently collected data from patients' charts. Demographics, clinical and nutritional status, identification of SAM and adherence to the 'WHO 10 Steps' were summarised. Their relationship to in-hospital mortality was assessed using multivariable logistic regression. Of the 6752 patients admitted, 9.7% had SAM. Mortality was significantly higher in those with SAM (10.1% HIV infection remains an important predictor of mortality in children with SAM. IV fluids should be avoided in those without shock. Early identification of SAM by the clinical team represents a focus of future quality improvement interventions at this facility.
Sections du résumé
BACKGROUND
Severe acute malnutrition (SAM) is a major cause of childhood mortality in resource-limited settings. The relationship between clinical factors and adherence to the 'WHO 10 Steps' and mortality in children with SAM is not fully understood.
METHODS
Data from an ongoing prospective observational cohort study assessing admission characteristics, management patterns and clinical outcome in children aged 6-36 months admitted to a tertiary hospital in Malawi from September 2018 to September 2019 were analysed. Data clerks independently collected data from patients' charts. Demographics, clinical and nutritional status, identification of SAM and adherence to the 'WHO 10 Steps' were summarised. Their relationship to in-hospital mortality was assessed using multivariable logistic regression.
RESULTS
Of the 6752 patients admitted, 9.7% had SAM. Mortality was significantly higher in those with SAM (10.1%
CONCLUSION
HIV infection remains an important predictor of mortality in children with SAM. IV fluids should be avoided in those without shock. Early identification of SAM by the clinical team represents a focus of future quality improvement interventions at this facility.
Identifiants
pubmed: 32242509
doi: 10.1080/20469047.2020.1747003
doi:
Substances chimiques
Blood Glucose
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM