Publication:

Risk factors of mortality in hospitalized children with severe acute malnutrition

Background Severe acute malnutrition (SAM) significantly contributes to morbidity and mortality in children globally. Identifying the factors associated with mortality is essential for reducing SAM-related deaths. This study aimed to identify the risk factors for mortality in hospitalized children with SAM.

Methods A case-control study was conducted at the SAM unit of the department of pediatrics, Institute of Child and Mother Health, Matuail, Dhaka, from January to December 2021. Children who died during hospitalization were classified as cases, while those who survived were controls. Data on socio-demographic, clinical, and laboratory parameters were collected. Statistical analyses were performed using SPSS version 22, employing student’s t-test and chi-square test for comparison, and univariate and multivariate logistic regression analyses to identify independent risk factors, with significance set at p<0.05.

Results The mean age of the subjects was 6.38±3.45 months for cases and 10.90±10.00 months for controls, indicating higher mortality in younger children. Mortality was more prevalent among males (61.5% versus 54.6%) and in families with a monthly income <10,000 Tk (53.8% in cases versus 21.9% in controls). Significant risk factors included dermatosis (46.2% versus 4.9%), oral ulcers (46.2% versus 5.5%), hypoglycemia (46.2% versus 3.8%), severe anemia (38.5% versus 2.2%), and septicemia (76.9% versus 29.5%). Multivariate analysis revealed hypoglycemia (OR=9.17, 95% CI 1.44-58.29) and severe anemia (OR=13.42, 95% CI 1.42-126.13) as strong predictors of mortality.

Conclusions Hypoglycemia and severe anemia are significant contributors to mortality among hospitalized children with SAM.