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

Table 3 Univariable and multivariable analyses of factors associated with post-discharge deaths amongst children admitted with diarrhea and residents of KHDSS

	Deaths (N = 49)^a	Univariable analysis			Multivariable analysis
	Deaths (N = 49)^a	Crude HR	95% CI	P value	Adjusted HR	95% CI	P value
Demographic features
Age (months)	–	1.00	0.97–1.02	0.80
Sex (female)	22 (45)	1.12	0.64–1.96	0.70
Prior hospital admission	20 (41)	4.71	2.66–8.32	< 0.001	3.11	1.57–6.17	0.001
Clinical features
Persistent diarrhea	3 (6.1)	3.51	1.11–11.13	0.03
Bloody diarrhea	1 (2.0)	0.90	0.12–6.46	0.92
Dehydration status
No dehydration	16 (33)	1.0	Reference
Some dehydration	9 (18)	0.90	0.40–2.04	0.80
Severe dehydration	24 (49)	1.92	1.02–3.61	0.04
Tachypnea^b	18 (37)	1.50	0.83–2.68	0.18
Tachycardia^c	19 (39)	0.95	0.53–1.68	0.85
Lower chest wall indrawing	16 (33)	2.90	1.59–5.26	< 0.001	2.00	1.03–3.79	0.04
Hypoxia (SaO2 < 90%)	2 (4.1)	2.03	0.49–8.34	0.33
Capillary refill > 2 s	6 (12)	3.16	1.35–7.43	0.008
Temperature gradient	7 (14)	1.85	0.83–4.12	0.13
Weak pulse	5 (10)	2.50	1.00–6.30	0.05
Impaired consciousness^d	6 (12)	2.75	1.17–6.45	0.02
Systematic lab test features
HIV antibody positive	18 (37)	13.76	7.60–24.91	< 0.001	5.02	2.31–10.92	< 0.001
Bacteremia	6 (12)	5.41	2.27–12.89	< 0.001	3.69	1.64–10.14	0.01
Malaria slide positive	3 (6.1)	1.52	0.47–4.93	0.48
Severe anemia (Hb < 5 g/dL)	6 (12)	4.20	1.78–9.90	0.001
Leucopenia^e (WBC < 4 × 10⁹/L)	1 (2.0)	4.07	0.52–32.09	0.18
Leucocytosis (WBC > 12 × 10⁹/L)	30 (61)	1.74	0.94–3.23	0.08
Nutritional status
Kwashiorkor	4 (8.2)	2.21	0.80–6.11	0.13
MUAC per centimeter		0.55	0.47–0.64	< 0.001	0.67	0.56–0.81	< 0.001
Height-for-age z score		0.62	0.52–0.73	< 0.001
Model performance
AUC (95% CI)					0.87 (0.81–0.94)
AIC					637.9

Variables’ missing results in the multivariable model were dropped using the stepwise approach. AUC area under receiver operating characteristics, AIC Akaike information criterion. ^aNumber of deaths and proportion of post-discharge deaths. ^bTachypnea was defined as respiration rate > 50 for children < 12 months and > 40 breaths/min for children ≥ 12 months. ^cTachycardia was defined as heart rate > 180 for children< 12 months and > 140 beats/min for children ≥ 12 months. ^dImpaired consciousness if “prostrate” or “unconscious.” ^eNormal white blood cell (WBC) count was 4 to 12 × 10⁹/L

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