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Table 1 Clinical and laboratory characteristics on admission by in-hospital mortality at 72 h

From: Lactate clearance as a prognostic marker of mortality in severely ill febrile children in East Africa

  Survivors Non-survivors Total Unadjusted OR of death (95% CI) p valuea
Number, N (%)b 2699 (90) 309 (10) 3008
General
 Female 1240/2699 (46) 147/309 (5) 1387/3008 (46) 1.07 (0.84, 1.35) 0.59
 Age (months); median (IQR)c 24 (14, 39) 23 (11, 38) 24 (13, 38.5) 0.77d
 Age < 12 months 494/2699 (16) 83/309 (3) 577/3008 (19) 1.64 (1.25, 2.15) < 0.001
 Middle-arm circumference ≤ 11.5 cm 56/2644 (1.95) 13/199 (0.5) 69/2843 (2.4) 3.23 (1.73, 6) < 0.001
 Axillary temperature > 39 °C 658/2694 (22) 45/309 (1) 703/3003 (23) 0.62 (0.44, 0.86) < 0.01
 Hypothermia (temperature < 36 °C) 133/2694 (4) 53/309 (2) 186/3003 (6) 3.99 (2.82, 5.64) < 0.001
Respiratory
 Respiratory rate; median (IQR)c 57 (48, 67) 60 (50, 70) 57 (48, 67) 0.03d
 Respiratory distress 2183/2688 (73) 280/308 (9) 2463/2996 (82) 2.31 (1.55, 3.46) < 0.001
 Deep breathing 1674/2697 (56) 261/308 (8) 1935/3005 (64) 2.47 (1.95, 3.14) < 0.001
 Hypoxaemia (oxygen saturation ≤ 90%) 521/2626 (18) 113/271 (4) 634/2897 (22) 2.89 (2.22, 3.76) < 0.001
 Crackles on auscultation 543/2697 (18) 112 /308 (4) 655/3005 (22) 2.27 (1.76, 2.92) < 0.001
Cardiovascular
 Severe tachycardiae 1955 /2697(73) 165/308 (54) 2120/3005 (71) 0.44 (0.34, 0.56) < 0.001
 Bradycardia 15/2698 (0.6) 2/3071 (7) 36/3005 (1.2) 13.13 (6.62, 26) < 0.001
 Capillary refill time:
  < 2 s 921/2696 (34) 53/308 (17) 974/3004 (32) 1.00 (Ref.)f  
  2–3 s 1130/2696 (42) 109/308 (35) 1239/3004 (41) 2.50 (1.83, 3.40) < 0.001
  ≥ 3 s 645/2696 (24) 146/308 (47) 791/3004 (26) 2.87 (2.25, 3.66) < 0.001
 Lower limb temperature gradientg 1544/2699 (57) 233/309 (75) 1777/3008 (59) 2.29 (1.75, 3.01) < 0.001
 Weak radial pulse 486/2699 (18) 149/309 (48) 635/3008 (21) 4.24 (3.30, 5.45) < 0.001
 Moderate hypotensionh 162/2664 (6) 40/289 (14) 202/2953 (7) 2.48 (1.71, 3.60) < 0.001
 Dehydration (sunken eyes or reduced skin turgor) 178/2697 (7) 51/307 (17) 229/3004 (8) 2.82 (2.01, 3.96) < 0.001
Neurological
 Level of consciousness:
  Alert 657 /2696(24) 22/309 (7) 679/3005 (23) 1.00 (Ref.)f  
  Prostratei 1714/2696 (64) 171/309 (55) 1885/3005 (63) 2.98 (1.89, 4.69) < 0.001
  Comaj 325/2696 (12) 116/309 (38) 441/3005 (15) 10.66 (6.63, 17.14) < 0.001
 Convulsions in this illness 301/2698 (11) 48/309 (16) 349/3007 (12) 1.40 (1.00, 1.95) 0.05
Clinical anaemia
 Severe pallork 969/2694 (36) 170 /309(55) 1139/3003 (38) 2.18 (1.71, 2.77) < 0.001
 Haemoglobinuria (history of dark urine) 339/2694 (1.4) 40/307 (13) 379/3001 (13) 1.21 (0.95, 1.54) 0.13
 Jaundice 833/2695 (31) 133/309 (43) 966/3004 (32) 1.65 (1.30, 2.10) < 0.001
Laboratory tests
 Lactate (mmol/L); median (IQR)c 3.4 (2.2, 6.9) 10.9 (5.2, 13.6) 3.8 (2.3, 8) < 0.001d
 Hyperlactataemia (lactate, mmol/L)
  No (< 2.5) 856/2699 (32) 25/309 (8) 881/3008 (29) 1.00 (Ref.)f  
  Moderate (2.5–5) 902/2699 (33) 46/309 (15) 948/3008 (32) 1.75 (1.06, 2.87) 0.03
  Severe (≥ 5) 941/2699 (35) 238/309 (77) 1179/3008 (39) 8.66 (5.6, 13.4) < 0.001
 Severe acidaemia:
  pH < 7.2 138/1816 (8) 70/208 (34) 208/2024 (10) 6.17 (4.35, 8.74) < 0.001
  Base deficit > −8 mmol/L 869/1809 (48) 170/203 (84) 1039/2012 (58) 5.57 (3.76, 8.26) < 0.001
  Bicarbonate < 15 mmol/L 588/1808 (3) 151/206 (73) 739/2014(37) 5.69 (4.07, 7.97) < 0.001
 Haemoglobin (g/dL):    2930   
  ≥ 10 648/2628 (25) 42/302 (14) 690/2930 (24) 1.00 (Ref.)f  
  7 to < 10 720/2628 (27) 80/302 (27) 800/2930 (27) 1.71 (1.16, 2.53) < 0.01
  5 to < 7 437/2628 (17) 45/302 (15) 482/2930 (16) 1.59 (1.02, 2.46) 0.04
  < 5 823 /2628(31) 135/302 (45) 958/2930 (33) 2.53 (1.76, 3.64) < 0.001
 Glucose (mmol/L); median (IQR)c 6.9 (5.5, 8.70) 5.95 (3.6, 9.1) 6.9 (5.4, 8.7) < 0.001d
 Hypoglycaemia (glucose < 2.5 mmol/L) 82/2615 (3) 48 /300(16) 130/915 (4) 5.88 (4.00, 8.66) < 0.001
 Blood urea nitrogen (BUN) ≥ 7.14 mmol/L 337/1819 (19) 90/205 (44) 427/2024 (21) 3.44 (2.54, 4.67) < 0.001
 Hyperkalaemia (≥ 6 mmol/L) 50/1768 (3) 37 /197(19) 87/1965 (4) 7.90 (4.98, 12.7) < 0.001
Microbiology
 Malaria parasitaemia, positivel 1571/2695 (58) 148/307 (48) 1719/3002 (57) 0.67 (0.53, 0.84) < 0.001
 HIV antibody, positive 86/2197 (4) 20/220 (9) 106/2417(4) 2.46 (1.48, 4.08) < 0.001
 Blood culture, positive 106/947 (11) 17/105 (16) 123 /1052 (12) 1.53 (0.88, 2.68) 0.13
  1. aChi-squared test p values
  2. bOf 3170 children enrolled in the FEAST trial, 162 did not have lactate measured at baseline
  3. cIQR: percentile 25, percentile 75
  4. dWilcoxon rank sum test p value
  5. eSevere tachycardia was defined as > 180 beats per minute (bpm) in children < 12 months, > 160 bpm in children aged 12 months to 5 years, and > 140 bpm for those aged > 5 years
  6. fRef: Reference group
  7. gTemperature gradient was assessed by running the back of the hand from the toe to the knee; a positive temperature gradient was defined as a notable temperature change from cold (dorsum of foot) to warm (knee)
  8. hModerate hypotension was defined as systolic blood pressure of 50–75 mmHg in children younger than 12 months, 60–75 mmHg in those 12 months to years, and 70–85 mmHg in those older than 5 years, as measured by automated blood pressure monitor
  9. iProstration was defined as the inability of a child older than 8 months of age to sit upright or the inability of a child 8 months of age or younger to breast feed
  10. jComa was defined as the inability to localise a painful stimulus
  11. kPallor manifested in lips, gums, or inner eyelids
  12. lPositive on quality-controlled malaria slide, or, if missing, on rapid diagnostic test