身高别体重Z评分和上臂中部周长作为重度急性营养不良儿童死亡率的预测指标
Weight-for-Height Z Score and Mid-Upper Arm Circumference as Predictors of Mortality in Children with Severe Acute Malnutrition.
作者信息
Chiabi Andreas, Mbanga Clarence, Mah Evelyn, Nguefack Dongmo Felicitee, Nguefack Seraphin, Fru Florence, Takou Virginie, Fru Angwafo
机构信息
Yaounde Gynaeco-Obstetric and Pediatric hospital/Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaoundé, Cameroon.
Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaoundé, Cameroon.
出版信息
J Trop Pediatr. 2017 Aug 1;63(4):260-266. doi: 10.1093/tropej/fmw083.
BACKGROUND
Mortality associated with severe acute malnutrition (SAM) could be reduced by screening malnourished children for those most vulnerable to death. We compared the weight-for-height Z score (WHZ) and mid-upper arm circumference (MUAC) as predictors of mortality in children with SAM.
METHODS
We conducted a retrospective study spanning over 8 years, using records of children aged 6-59 months, hospitalized for SAM and discharged alive or who died during hospitalization.
RESULTS
Area under the curve was greater for MUAC [0.809 (95% CI, 0.709-0.911, p = 0.001)] than WHZ [0.649 (95% CI, 0.524-0.774, p = 0.032)]. MUAC predicted death better [sensitivity: 95.5%, specificity: 25.0%, positive likelihood ratio (PLR): 1.27, negative likelihood ratio (NLR): 0.18] than WHZ (sensitivity: 86.4%, specificity: 21.4%, PLR: 1.10, NLR: 0.64). Best MUAC and WHZ cut-offs for predicting death (10.3 cm and -4, respectively) were most accurate in infants aged <12 months, the former being more accurate.
CONCLUSION
MUAC predicts death better than WHZ in children with SAM.
背景
通过筛查营养不良儿童中最易死亡的个体，可降低与重度急性营养不良（SAM）相关的死亡率。我们比较了身高别体重Z评分（WHZ）和上臂中部周长（MUAC）作为SAM患儿死亡率预测指标的情况。
方法
我们进行了一项为期8年多的回顾性研究，使用6至59个月大因SAM住院且出院时存活或住院期间死亡儿童的记录。
结果
MUAC的曲线下面积[0.809（95%CI，0.709 - 0.911，p = 0.001）]大于WHZ[0.649（95%CI，0.524 - 0.774，p = 0.032）]。MUAC对死亡的预测效果[敏感性：95.5%，特异性：25.0%，阳性似然比（PLR）：1.27，阴性似然比（NLR）：0.18]优于WHZ（敏感性：86.4%，特异性：21.4%，PLR：1.10，NLR：0.64）。预测死亡的最佳MUAC和WHZ临界值（分别为10.3 cm和 -4）在<12个月的婴儿中最准确，前者更准确。
结论
在SAM患儿中，MUAC对死亡的预测优于WHZ。
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