title: Risk factors of mortality in severely-malnourished children hospitalized with diarrhoea.
abstract: This case-control study was conducted in the Dhaka Hospital of ICDDR,B to identify the risk factors of mortality in severely-malnourished children hospitalized with diarrhoea. One hundred and three severely-malnourished children (weight-for-age <60% of median of the National Center for Health Statistics standard) who died during hospitalization were compared with another 103 severely-malnourished children who survived. These children were aged less than three years and admitted to the hospital during 1997. On admission, characteristics of the fatal cases and non-fatal controls were comparable, except for age. The median age of the cases and controls were six and eight months respectively (p = 0.05). Patients with low pulse rate or imperceptible pulse had three times the odds of death compared to the control group (p < 0.01). The presence of clinical septicaemia and clinical severe anaemia had 11.7 and 4.2 times the odds of death respectively (p < 0.01). Patients with leukocytosis (> 15,000/cm3) had 2.5 times the odds of death (p < 0.01). Using logistic regression, clinical septicaemia [adjusted odds ratio (AOR) = 8.8, confidence interval (CI) 3.7-21.1, p = 0.01], hypothermia (AOR = 3.5, CI 1.3-9.4, p < 0.01), and bronchopneumonia (AOR=3.0, CI 1.2-7.3, p < 0.01) were identified as the significant risk factors of mortality. Severely-malnourished children (n=129) with leukocytosis, imperceptible pulse, pneumonia, septicaemia, and hypothermia had a high risk of mortality. The identified risk factors can be used as a prognostic guide for patients with diarrhoea and severe malnutrition.
authors.affiliation: ICDDR,B, GPO Box 128, Dhaka 1000, Bangladesh. skroy@icddrb.org
authors.forename: S K
authors.initials: SK
authors.lastname: Roy
authors.forename: Maaike
authors.initials: M
authors.lastname: Buis
authors.forename: Renee
authors.initials: R
authors.lastname: Weersma
authors.forename: Wajiha
authors.initials: W
authors.lastname: Khatun
authors.forename: S
authors.initials: S
authors.lastname: Chowdhury
authors.forename: Afroza
authors.initials: A
authors.lastname: Begum
authors.forename: Debjani
authors.initials: D
authors.lastname: Sarker
authors.forename: Saima Kamal
authors.initials: SK
authors.lastname: Thakur
authors.forename: Mansura
authors.initials: M
authors.lastname: Khanam
mesh_terms: D001459:Bangladesh / Q000453:epidemiology; D016022:Case-Control Studies; D015362:Child Nutrition Disorders / Q000150:complications*; D002675:Child, Preschool; D003967:Diarrhea / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality* / Q000628:therapy; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D009752:Nutritional Status; D012307:Risk Factors; D018805:Sepsis / Q000150:complications / Q000401:mortality; D011795:Surveys and Questionnaires