Serum albumin concentration, arm circumference, and oedema and subsequent risk of dying in children in central Africa.
OBJECTIVE
To measure the prognostic value of clinical, anthropometric, and biological indicators of protein energy malnutrition in hospitalised children.


METHODS
Hospital based follow up study from admission to discharge or death of a cohort of children. SETTING-Paediatric hospital in Zaire.


METHODS
1129 children consecutively admitted between August 1986 and October 1988.


METHODS
Height, weight, arm circumference, skinfold thicknesses, serum albumin concentration, and mortality.


RESULTS
Mortality was higher in wasted children and in those with a mid-upper arm circumference < 125 mm, a serum albumin concentration < 16 g/l, and oedema. After multivariate analysis, serum albumin concentration was the best predictor of subsequent risk of dying. Mid-upper arm circumference and oedema, however, still contributed considerably to evaluation of mortality.


CONCLUSIONS
In this specific environment of central Africa an isolated clinical sign such as oedema is not enough to detect children with a high risk of dying among those admitted to paediatric wards with severe protein energy malnutrition. Measurement of additional indicators such as arm circumference and serum albumin concentration seems to be of crucial importance.
Dramaix
M
M
School of Public Health, Free University of Brussels, Belgium.
Hennart
P
P
Brasseur
D
D
Bahwere
P
P
Mudjene
O
O
Tonglet
R
R
Donnen
P
P
Smets
R
R
D000886:Anthropometry; D001132:Arm / Q000033:anatomy & histology; D001827:Body Height; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D004487:Edema / Q000401:mortality*; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007902:Length of Stay; D011379:Prognosis; D011502:Protein-Energy Malnutrition / Q000097:blood / Q000401:mortality*; D012709:Serum Albumin / Q000032:analysis*
D012709:Serum Albumin