Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.
Indian J Pediatr. 2010 Aug;77(8):885-8. doi: 10.1007/s12098-010-0125-y. Epub 2010 Aug 27.
To identify risk factors associated with Persistent diarrhea (PD) and deaths due to PD.
This prospective case control study included 60 children with PD (cases) and 60 children (controls) with acute diarrhoea (AD). Detailed history, examination and appropriate investigations were done for all children. Crude Odds ratio was calculated for each risk factor by univariate analysis and adjusted odds ratio was calculated by multivariate logistic regression.
Prior antibiotic use, steroid use, anemia, vitamin A deficiency, malnutrition, LRI, UTI, oral candidiasis, and hyponatremia, were statistically significant risk factors by univariate analysis. Prior antibiotic use, vitamin A deficiency, malnutrition and LRI were independently associated with PD by multivariate logistic regression analysis. The risk factors for mortality were stool frequency more than 10 times per day, severe malnutrition, oral candidiasis, hypoalbuminemia and HIV positivity.
The presence of these risk factors should alert the clinician to take appropriate measures, to decrease the mortality.
确定与持续性腹泻(PD)和 PD 导致的死亡相关的风险因素。
这项前瞻性病例对照研究纳入了 60 例 PD 患儿(病例)和 60 例急性腹泻(AD)患儿(对照)。对所有患儿均进行详细的病史询问、体格检查和适当的检查。通过单因素分析计算每个风险因素的粗比值比,通过多因素 logistic 回归计算调整后的比值比。
单因素分析显示,既往使用抗生素、使用类固醇、贫血、维生素 A 缺乏、营养不良、下呼吸道感染、尿路感染、口腔念珠菌病和低钠血症均为统计学显著的风险因素。多因素 logistic 回归分析显示,既往使用抗生素、维生素 A 缺乏、营养不良和下呼吸道感染与 PD 独立相关。死亡的风险因素为每天排便超过 10 次、严重营养不良、口腔念珠菌病、低白蛋白血症和 HIV 阳性。
这些风险因素的存在应引起临床医生的注意,以便采取适当的措施降低死亡率。