Risk factors of mortality in severely-malnourished children hospitalized with diarrhoea

This case-control study was conducted in the dhaka hospital of icddr,b to identify the risk factors of mortality in severely-malnourished children hospitalized with diarrhoea. one hundred and three severelymalnourished children (weight-for-age <60% of median of the national center for health statistics standard) who died during hospitalization were compared with another 103 severely-malnourished children who survived. these children were aged less than three years and admitted to the hospital during 1997. on admission,characteristics of the fatal cases and non-fatal controls were comparable,except for age. the median age of the cases and controls were six and eight months respectively (p=0.05). patients with low pulse rate or imperceptible pulse had three times the odds of death compared to the control group (p<0.01). the presence of clinical septicaemia and clinical severe anaemia had 11.7 and 4.2 times the odds of death respectively (p<0.01). patients with leukocytosis (>15,000/cm 3) had 2.5 times the odds of death (p<0.01). using logistic regression,clinical septicaemia [adjusted odds ratio (aor)=8.8,confidence interval (ci) 3.7-21.1,p=0.01],hypothermia (aor=3.5,ci 1.3-9.4,p<0.01),and bronchopneumonia (aor=3.0,ci 1.2-7.3,p<0.01) were identified as the significant risk factors of mortality. severely-malnourished children (n=129) with leukocytosis,imperceptible pulse,pneumonia,septicaemia,and hypothermia had a high risk of mortality. the identified risk factors can be used as a prognostic guide for patients with diarrhoea and severe malnutrition. © international centre for diarrhoeal disease research,bangladesh.