Recovery of children following hospitalisation for complicated severe acute malnutrition

Datos Bibliográficos

ID15537190
AutoresMutsa Bwakura-Dangarembizi (0000-0001-7751-6177, University of Zimbabwe, autor de correspondencia), Cherlynn Dumbura (0000-0002-1704-0274, Zvitambo Institute for Maternal and Child Health Research), Beatrice Amadi (0000-0001-6363-2943, University of Zambia), Bernard Chasekwa (0000-0001-8080-7573, Zvitambo Institute for Maternal and Child Health Research), Deophine Ngosa (0000-0002-9019-9046, University of Zambia), Florence D Majo (0009-0006-1282-0462, Zvitambo Institute for Maternal and Child Health Research), Jonathan P Sturgeon (0000-0003-1318-1739, Queen Mary University of London), Kanta Chandwe (0000-0003-1403-8432, University of Zambia), Chanda Kapoma (0000-0001-6404-1686, University of Zambia), Claire D Bourke (0000-0002-7244-0895, Queen Mary University of London), Ruairi C Robertson (0000-0002-3719-2056, Queen Mary University of London), Kusum J Nathoo (University of Zimbabwe College of Health Sciences Harare Zimbabwe), Kusum Nathoo (University of Zimbabwe), Robert Ntozini (0000-0002-8543-2835, Zvitambo Institute for Maternal and Child Health Research), Shane A Norri (0000-0001-7124-3788, University of the Witwatersrand), Shane A Norris (University of Witwatersrand Johannesburg South Africa), Paul Kelly (0000-0003-1946-9848, Queen Mary University of London), Andrew J Prendergast (0000-0001-7904-7992, Queen Mary University of London)
Año2021
Volumen18
Número2
Páginase13302-e13302
Fecha de publicación2021-12-22
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaMaternal and Child Nutrition (JOURNAL)
Identificadores de la revistaISSN: 1740-8695 • E-ISSN: 1740-8709
EditorialWiley (PUBLISHER • GB)
DOI10.1111/mcn.13302
PMID34939325
OpenAlexW4200065676
IdiomaEN
Citas recibidas5
Referencias citadas32

Nutritional recovery and hospital readmission following inpatient management of complicated severe acute malnutrition (SAM) are poorly characterised. We aimed to ascertain patterns and factors associated with hospital readmission, nutritional recovery and morbidity, in children discharged from hospital following management of complicated SAM in Zambia and Zimbabwe over 52-weeks posthospitalization. Multivariable Fine-Gray subdistribution hazard models, with death and loss to follow-up as competing risks, were used to identify factors associated with hospital readmission; negative binomial regression to assess time to hospitalisation and ordinal logistic regression to model factors associated with nutritional recovery. A total of 649 children (53% male, median age 18.2 months) were discharged to continue community nutritional rehabilitation. All-cause hospital readmission was 15.4% (95% CI 12.7, 18.6) over 52 weeks. Independent risk factors for time to readmission were cerebral palsy (adjusted subhazard ratio (aSHR): 2.96, 95% CI 1.56, 5.61) and nonoedematous SAM (aSHR: 1.64, 95%CI 1.03, 2.64). Unit increases in height-for-age Z-score (HAZ) (aSHR: 0.82, 95% CI 0.71, 0.95) and enrolment in Zambia (aSHR: 0.52, 95% CI 0.28, 0.97) were associated with reduced subhazard of time to readmission. Young age, SAM at discharge, nonoedematous SAM and cerebral palsy were associated with poor nutritional recovery throughout follow-up. Collectively, nonoedematous SAM, ongoing SAM at discharge, cerebral palsy and low HAZ are independent risk factors for readmission and poor nutritional recovery following complicated SAM. Children with these high-risk features should be prioritised for additional convalescent care to improve long-term outcomes

Cerebral palsy · Logistic regression · Malnutrition · Physical therapy · Severe Acute Malnutrition · Child Nutrition and Feeding Issues · Child Nutrition and Water Access · Clinical Nutrition and Gastroenterology · Medicine · Emergency Medicine · Internal Medicine · Pediatrics