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Mortality after inpatient treatment for diarrhea in children: A cohort study

BMC Medicine Feb 01, 2019

Talbert A, et al. - In this retrospective cohort study, researchers evaluated the incidence and demographic, clinical, and biochemical features correlated with inpatient and 1-year post-discharge mortality amongst children (aged 2–59 months) admitted with diarrhea from 2007 to 2015 at Kilifi County Hospital and who were residents of Kilifi Health and Demographic Surveillance System (KHDSS). To identify risk factors for inpatient mortality, log-binomial regression was used. No difference in inpatient and post-discharge mortality was observed between diarrhea and other diagnoses other than severe pneumonia. Findings suggested an association of HIV, low mid-upper arm circumference (MUAC), and bacteremia with both inpatient and post-discharge mortality. Signs of circulatory impairment, sepsis and abnormal electrolytes were linked to inpatient mortality, but not post-discharge mortality. Prior admission and lower chest wall indrawing were not associated with inpatient mortality but with post-discharge mortality. Before or after discharge, age, stuntedness, and persistent or bloody diarrhea were not related to mortality. The outcomes emphasized the need for research to improve the use and outcomes of malnutrition and HIV services and to clarify causal pathways and test interventions to mitigate these risks.
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