International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
Sylhet Osmani Medical College Hospital, Sylhet, Bangladesh.
J Infect Dev Ctries. 2022 Jun 30;16(6):1075-1080. doi: 10.3855/jidc.15376.
There is lack of data on outcomes of severely malnourished children who are hospitalized with concomitant diarrhea and vomiting. We sought to evaluate outcomes of such children.
In this retrospective chart review, we used electronic databases to evaluate children aged 0-59 months and admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh, with diarrhea and severe malnutrition between April 2011 and August 2012. Outcomes of children with and without vomiting were compared. The primary outcome was death. A probability of ≤ 0.05 was considered statistically significant.
Out of 306 enrolled children, 51 (17%) had vomiting and 255 (83%) did not have vomiting. A total of 31 (10%) children died, 12 (24%) of them had vomiting and 19 (8%) did not have vomiting. Death was significantly higher in severely malnourished diarrheal children with vomiting (12/51 (24%)) compared to those without vomiting (19/255 (8%)) (Relative risk [RR] 2.73, 95% confidence interval [CI] 1.61-4.64; p < 0.001). We used Log linear bi-nominal regression after adjusting for potential confounders such as metabolic acidosis and hypoglycemia, and found that vomiting was significantly associated with deaths in severely malnourished diarrheal children (RR 1∙89, 95% CI 1.01-1.33; p = 0.05).
Our analysis showed that children with diarrhea and severe malnutrition who had vomiting during hospitalization were at a higher risk of death compared to those without vomiting. The results underscore the importance of prompt identification and management of vomiting to reduce deaths in such children.
目前缺乏同时患有腹泻和呕吐的严重营养不良儿童住院治疗结局的数据。我们旨在评估此类儿童的结局。
在这项回顾性图表研究中，我们使用电子数据库评估了 2011 年 4 月至 2012 年 8 月期间在孟加拉国国际腹泻病研究中心达卡医院因腹泻和严重营养不良而住院的 0-59 月龄儿童。比较了有呕吐和无呕吐儿童的结局。主要结局为死亡。概率≤0.05 被认为具有统计学意义。
306 名入组儿童中，51 名（17%）有呕吐，255 名（83%）无呕吐。共有 31 名（10%）儿童死亡，其中 12 名（24%）有呕吐，19 名（8%）无呕吐。有呕吐的严重营养不良性腹泻儿童（12/51（24%））的死亡率明显高于无呕吐的儿童（19/255（8%））（相对风险 [RR] 2.73，95%置信区间 [CI] 1.61-4.64；p < 0.001）。在调整了代谢性酸中毒和低血糖等潜在混杂因素后，我们使用对数线性二项式回归，发现呕吐与严重营养不良性腹泻儿童的死亡显著相关（RR 1.89，95%CI 1.01-1.33；p = 0.05）。
我们的分析表明，与无呕吐的儿童相比，住院期间有腹泻和严重营养不良且伴有呕吐的儿童死亡风险更高。研究结果强调了及时识别和处理呕吐以降低此类儿童死亡率的重要性。
