Survival analysis of patients with severe acute malnutrition admitted at the in-patient therapeutic care of the Bicol Regional Training and Teaching Hospital
https://doi.org/10.47895/amp.vi0.5851
- Author:
Arlene Pabustan-Calleja
1
;
Vincent B. Aguilar
1
;
Ma. Leonor Castillo-Reyes
1
Author Information
1. Department of Pediatrics, Bicol Regional Training and Teaching Hospital
- Publication Type:Journal Article
- Keywords:
Community management of acute malnutrition;
In-patient therapeutic care
- MeSH:
Severe Acute Malnutrition;
Survival Analysis
- From:
Acta Medica Philippina
2024;58(3):5-14
- CountryPhilippines
- Language:English
-
Abstract:
Background:Severe acute malnutrition (SAM) in children under five years remains a major global health concern. It carries a burden to the overall health of a child, contributes to mortality, and adds financial strain to the family and the hospital. The Philippine Integrated Management of Acute Malnutrition was established to address acute malnutrition in Filipino children.
Objective:This study aimed to determine the factors affecting survival of patients admitted at Bicol Regional Training and Teaching Hospital (BRTTH) In-patient Therapeutic Care (ITC).
Methods:This is a retrospective cohort study design utilizing survival analysis. Accrual period was from January 1, 2018 to December 31, 2018. Follow-up ended on March 31, 2019. There were 154 admissions and excluded 17 missing charts. Survival analysis was done utilizing STATA 14.
Results:The prevalence of SAM requiring ITC admission was 3.0 percent. Majority belonged to 6-59 months of age (63%), with equal predilection for both sexes (1:1) and 71% came from the home province, Albay. Most of patients’ caretakers had middle educational attainment. Sixty-eight percent (68%) were new patients, 16% readmitted, 15% transferred from the Out-patient Therapeutic Care (OTC) and <1% relapsed. The top three most common complications and co-morbidities include: pneumonia, low electrolytes, and fever. Sixty-three percent (63%) of patients at the ITC had a desirable treatment outcome, of which, 8% were cured and 55% transferred to OTC. Undesirable outcomes accounted for 37% of the cases which included non-cured, defaulter, and died at 12%, 8%, and 17%, respectively. The risk of dying was higher in SAM patients with parents having middle and low educational attainment as compared to those with high educational attainment (2-5 folds to 100-200 folds). SAM patients presenting with hypovolemic shock were likely to die by 1.5-19 times (1.5-19x) as compared to those without. SAM patients with malignancy were more likely to die 4-44 folds as compared to patients without malignancy.
Conclusion and Recommendations:Educational attainment of parents, malignancy, and hypovolemic shock were significant predictors of mortality. We recommend prompt intervention by educating families, strengthen policies targeting socio-economic determinants, capacitate medical staff, refine current clinical practice guidelines and treatment pathways to reduce the number of children who die from severe acute malnutrition.
- Full text:5851-Article Text-99739-2-10-20240227.pdf
