[Mortality in breast-fed infants with persistent diarrhea: risk factors associated with death].
OBJECTIVE
Persistent diarrhea is a frequent disease in developing countries. In this research, we studied 21 patients that passed away among 189 that were hospitalized with persistent diarrhea at the "Hospital Italo Brasileiro Umberto I Foundation", from January of 1985 until December of 1992.


METHODS
The patients were distributed into two groups: survival and dead, in accord of the clinical evolution at the end of the internment. The analyzed parameters were: birth weight, sex, age, provenance, diarrhea period before the admission, nutritional status, hydration status, coprologic results, occurrence of food intolerance, internment period and the age of ending breast-feeding.


RESULTS
The parameters that showed significantly association with the death were: age, with relative risk = 3 for children with age below 6 months old; provenance, with relative risk = 3.4 for patients who were arrived from other hospitals; third grade dehydration at the admission (relative risk = 2.9); enteropathogenic Escherichia coli (EPEC) isolated in feces (relative risk = 3.3), and use of total parenteral nutrition. The etiologic research was positive in 57.1% of the cases. The enteropathogen more frequently isolated in dead group, was EPEC (42.9%), followed by Shigella (9.5%) and Salmonella (5.9%). From the isolated EPEC (35/189), 26 (74.3%) were belonged to the OIII sorogroup (6/26). From these children, 23.1% died. From the 35 patients with EPEC isolated in feces, 25 were below 6 months old, and from these one, eight died. The relative risk to die for lactents with less than 6 months old and EPEC in feces was equal 3.2. Sepsis was considered the most important cause of death for hospitalized lactents with persistent diarrhea.
Escola Paulista de Medicina, Universidade Federal de São Paulo EPM-UNIFESP.
J A
JA
de Andrade
T A
TA
Gomes
U
U
Fagundes-Neto
D000367:Age Factors; D003968:Diarrhea, Infantile / Q000401:mortality*; D005260:Female; D006801:Humans; D007223:Infant; D007410:Intestinal Diseases / Q000209:etiology; D007902:Length of Stay; D008297:Male; D012307:Risk Factors; D014886:Weaning