Post-hospital mortality in children aged 2-12 years in Tanzania: A prospective cohort study.
Post-hospital mortality in children aged 2-12 years in Tanzania: A prospective cohort study.
Blog Article
BACKGROUND:Sub-Saharan Africa has the highest rates of child mortality worldwide.Little is known about post-hospital outcomes after an index hospitalization for older children.We determined 12-month post-hospital mortality rate and identified factors associated with higher mortality.METHODS:In this prospective cohort study, we enrolled children 2-12 years of age admitted to the pediatric wards of two public hospitals in northwestern Tanzania.Participants or proxies were contacted at 3, 6 and 12 months post-hospitalization.
The primary outcome measured was mortality.Factors associated with mortality were determined using Cox regression analysis.RESULTS:A total of 506 participants were enrolled.In-hospital mortality rate was 7.7% (39/506).
Of the 467 Footcare Health participants discharged, the post-hospital mortality rate was 10.1% (47/467).Sickle cell disease (Hazard Ratio (HR) 3.32, 95% CI 1.44-7.
68), severe malnutrition (HR 3.19, 95% CI 1.18-8.57), neurologic diseases (HR 3.51, 95% CI 1.
35-9.11), heart disease (HR 7.11, 95% CI, 2.89-17.51), cancer (HR 11.
79, 95% CI 4.95-28.03), and septic shock (HR 4.64, 95% CI 1.42-15.
08) had higher association with mortality compared to other diagnoses.The risk factors significantly associated with mortality included older age (HR 1.01, 95% CI 1.00-1.08), lower hemoglobin level (HR 0.
83, 95% CI 0.76-0.90), lower Glasgow Coma Scale (HR 0.66, 95% CI 0.59-0.
74), history of decreased urine output (HR 2.87, 95% CI 1.49-5.53), higher respiratory rate (HR 1.02, 95% CI 1.
00-1.03), estimated glomerular filtration rate less RXOMEGA-3 900MG than 60 ml/min/1.73m2 (binary) (HR 1.84, 95% CI 1.10-3.
10), and lower oxygen saturation (HR 0.96, 95% CI 0.92-0.99).CONCLUSIONS:Post-hospital mortality is disturbingly high among children 2-12 years of age in Tanzania.
Post-hospital interventions are urgently needed especially for older children with chronic illnesses.