Author(s): Chisti MJ, Pietroni MA, Smith JH, Bardhan PK, Salam MA
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Abstract 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. © 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.
This article was published in Acta Paediatr
and referenced in Journal of Clinical Case Reports