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.
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DOI：
10.1371/journal.pone.0202334
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Peck RN
中科院分区：
文献类型：
--
作者：
Hau DK;Chami N;Duncan A;Smart LR;Hokororo A;Kayange NM;Peck RN
撒哈拉以南非洲地区的儿童死亡率是全世界最高的。对于年龄较大的儿童住院后的出院结果知之甚少。我们确定了 12 个月的出院后死亡率并确定了与较高死亡率相关的因素。在这项前瞻性队列研究中，我们招募了坦桑尼亚西北部两家公立医院儿科病房的 2-12 岁儿童。在住院后 3、6 和 12 个月时联系参与者或代理人。测量的主要结果是死亡率。使用Cox回归分析确定与死亡率相关的因素。共有 506 名参与者报名。院内死亡率为7.7%（39/506）。在 467 名出院参与者中，出院后死亡率为 10.1% (47/467)。镰状细胞病（风险比 (HR) 3.32，95% CI 1.44–7.68）、严重营养不良（HR 3.19，95% CI 1.18–8.57）、神经系统疾病（HR 3.51，95% CI 1.35–9.11）、心脏病（HR 7.11，95% CI 1.35–9.11）、心脏病（HR 7.11，95% CI与其他诊断相比，癌症（HR 11.79，95% CI 4.95-28.03）和感染性休克（HR 4.64，95% CI 1.42-15.08）与死亡率的相关性更高。与死亡率显着相关的危险因素包括年龄较大（HR 1.01，95% CI 1.00–1.08）、较低的血红蛋白水平（HR 0.83，95% CI 0.76–0.90）、较低的格拉斯哥昏迷量表（HR 0.66，95% CI 0.59–0.74）、尿量减少史（HR 2.87，95%） CI 1.49–5.53）、较高的呼吸频率（HR 1.02，95% CI 1.00–1.03）、估计肾小球滤过率低于 60 ml/min/1.73m2（二元）（HR 1.84，95% CI 1.10–3.10）和较低的氧饱和度（HR 0.96，95% CI） 0.92–0.99）。坦桑尼亚 2-12 岁儿童的出院后死亡率高得令人不安。迫切需要出院后干预，特别是对于患有慢性病的年龄较大的儿童。
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. 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. A total of 506 participants were enrolled. In-hospital mortality rate was 7.7% (39/506). Of the 467 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 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). 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.
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影响因子：
105.7
作者：
ROY, SK;CHOWDHURY, AKMA;RAHAMAN, MM
通讯作者：
RAHAMAN, MM
影响因子：
3.7
作者：
Wiens MO;Pawluk S;Kissoon N;Kumbakumba E;Ansermino JM;Singer J;Ndamira A;Larson C
通讯作者：
Larson C
影响因子：
34.3
作者：
Peck, Robert;Mghamba, Janneth;Vanobberghen, Fiona;Kavishe, Bazil;Rugarabamu, Vivian;Smeeth, Liam;Hayes, Richard;Grosskurth, Heiner;Kapiga, Saidi
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Kapiga, Saidi
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168.9
作者：
You, Danzhen;Hug, Lucia;Alkema, Leontine
通讯作者：
Alkema, Leontine
影响因子：
2
作者：
Islam, MA;Rahman, MM;Rahman, AKSM
通讯作者：
Rahman, AKSM