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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
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