Post-Discharge survival status and predictors of mortality among severely acute malnourished children <5 years of age admitted to Minia University Maternity and Children Hospital

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Abstract Background: Though effective treatment programs for severely malnourished children are available, but little is known about long-term outcomes and potential predictors of post-discharge mortality. The aim of this study was to assess the post-discharge survival status and predictors for post-discharge mortality in severely malnourished children admitted to Minia University Maternity and Children Hospital Methods: A retrospective cohort study which included 135 children under five years of age who were admitted to the nutrition rehabilitation ward with severe acute malnutrition (SAM) during the period from January to December 2018. Data were collected from the inpatients hospital records and children’s parents/guardians were interviewed using a detailed structured questionnaire that inquired about demographic and socioeconomic variables. Results: A total of 135 children were enrolled into the study. Death rate during hospitalization was 9.6%. The cumulative probability of survival beyond eight weeks and at least for 24 weeks after discharge was 89.3% with a cumulative probability of post-discharge mortality of 10.7% and all deaths occurred within eight weeks after discharge. The main predictors for post-discharge mortality were illiteracy of mothers and the presence of edema at admission; the multivariable HRs (95%CIs) were 7.10 (1.58-31.93; p=0.01) and 6.96 (0.84-357.85; p=0.07), respectively. Conclusions: Mothers’ education and edema at admission are independent predictors for post-discharge mortality in under-five children with SAM. The identification of predictors for post-discharge mortality is an important preliminary step for interventions aiming to reduce morbidity and mortality following discharge.

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