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Predictors of death in under‐five children with diarrhoea admitted to a critical care ward in an urban hospital in Bangladesh
Author(s) -
Chisti Mohammod J,
Pietroni Mark AC,
Smith Jonathan H,
Bardhan Pradip K,
Salam Mohammed A
Publication year - 2011
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2011.02368.x
Subject(s) - medicine , malnutrition , pediatrics , severe acute malnutrition , pneumonia , diarrhea , diarrhoeal disease , prospective cohort study , cohort study
Aim : To evaluate the clinical and laboratory predictors of death in hospitalized under‐five children with diarrhoea. Methods : This is a prospective cohort study carried out in the Special Care Ward (SCW) of the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh. All admitted diarrhoeal children of both sexes, aged 0–59 months, from September 2007 through December 2007 were enrolled. We compared and analysed factors among diarrhoeal children who died (n = 29) with those who survived (n = 229). Results : In logistic regression analysis, after adjusting for potential confounders (infusion of intravenous fluid and immature PMN), absent peripheral pulse even after complete rehydration (OR 10.9, 95% CI 2.1–56.8; p < 0.01), severe malnutrition (OR 7.9, 95% CI 1.8–34.8; p < 0.01), hypoxaemia (OR 8.5, 95% CI 1.0‐75.0; p = 0.05), radiological lobar pneumonia (OR 17.8, 95% CI 3.7–84.5; p < 0.01) and hypernatraemia (OR 15.8, 95% CI 3.0–81.8; p < 0.01) were independently associated with deaths among diarrhoeal children admitted to SCW. Conclusions: Thus, the absence of peripheral pulses even after full rehydration, severe malnutrition, hypoxaemia, lobar pneumonia and hypernatraemia are independent predictors of death among the under‐five children with diarrhoea admitted to critical care ward of a resource‐limited setting in Bangladesh.