article · BMC Research Notes
Severe acute malnutrition remains associated with high hospital case-fatality rates in parts of Africa despite existing management protocols. A retrospective cohort study examined 569 medical records of children admitted to stabilization centres across general hospitals in the Tigray region of northern Ethiopia over a 24-month period. Most patients, representing 82 percent of the cohort, were cured, while 6.65 percent absconded and 3.8 percent died during treatment. The overall mean survival time was approximately 42 days. Multivariable analysis identified three statistically significant predictors of mortality: impaired consciousness at admission, the development of new comorbidities during hospitalisation, and living in an urban residence. The findings indicate that inpatient treatment strategies must focus targeted clinical care towards severely malnourished children who exhibit reduced consciousness or who acquire secondary health conditions following hospital admission.
Even within hospital settings using established management protocols, severe acute malnutrition in young children can prove fatal. Identifying clinical warning signs, such as impaired consciousness and secondary infections or complications acquired after admission, allows hospital staff to prioritise intensive monitoring and rapid intervention for the patients at the greatest risk of dying.
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OBJECTIVE: Despite the presence standard protocol for management of severe acute malnutrition case-fatality rates in African hospitals remain unacceptably high. The case in Ethiopia is not different from others. Therefore, this study was aimed to assess survival status and predictors of mortality among children with severe acute malnutrition admitted to stabilization centers of general hospitals in Tigray region, northern Ethiopia. A 24 months retrospective longitudinal study was conducted among 569 randomly selected medical records of children admitted to stabilizing centers. Both bi-variable and multivariable Cox regression analysis was conducted to identify predictors of mortality. Association was summarized using AHR, and statistical significances were declared at 95% CI and P-value < 0.05. RESULTS: During follow up, 456 [82%] of children had got cured, 37 [6.65%] were absconded and 21 [3.8%] were died. The overall mean survival time was 41.93 [95% CI 40.17-43.68] days. Impaired conscious level [AHR = 6.69, 95% CI 2.43-19.93], development of comorbidity after admission [AHR 12.71, 95% CI 2.79-57.94] and being urban in residence [AHR = 2.73, 95% CI 1.12-6.64] were predictors of mortality. Therefore, interventions to reduce further mortality should focus in children having impaired consciousness level and who developed comorbidity after admission.
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DOI: 10.1186/s13104-018-3937-x
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