Table 3.
Risk of 2-week mortality controlling for WHO IMCI referral criteria and SpO2 measurement in outpatient children aged 3–11 months with suspected pneumonia in rural Bangladesh
| Risk ratio*(95% CI) | p value | Adjusted risk ratio*(95% CI) | p value | |
|---|---|---|---|---|
| WHO IMCI and no SpO2measurement (n=3848) | ||||
| WHO IMCI referral criteria† | 3·8 (1·5–9·4) | 0·0046 | .. | .. |
| WHO IMCI and SpO2continuous (n=3781) | ||||
| WHO IMCI referral criteria† | 3·8 (1·5–9·4) | 0·0046 | 4·0 (1·5–10·7) | 0·0054 |
| SpO2 | 0·9 (0·8–0·9) | <0·0001 | 0·9 (0·8–0·9) | <0·0001 |
| WHO IMCI and SpO2strata (n=3848) | ||||
| WHO IMCI referral criteria† | 3·8 (1·5–9·4) | 0·0046 | 3·1 (1·2–7·9) | 0·0193 |
| 90–93% | 4·6 (1·6–12·9) | 0·0040 | 4·3 (1·5–11·8) | 0·0048 |
| <90% | 11·0 (3·6–33·5) | <0·0001 | 10·3 (3·2–32·3) | 0·0001 |
| Failed SpO2measurement | 12·6 (3·6–43·5) | 0·0001 | 11·4 (3·1–41·4) | 0·0002 |
| WHO IMCI and SpO2<90% or failed measurement attempt (n=3848) | ||||
| WHO IMCI referral criteria† | 3·8 (1·5–9·4) | 0·0046 | 3·3 (1·2–8·7) | 0·0163 |
| <90% or failed SpO2measurement | 9·0 (3·7–21·3) | <0·0001 | 8·2 (3·2–20·6) | <0·0001 |
| WHO IMCI and SpO2<94% or failed measurement attempt (n=3848) | ||||
| WHO IMCI referral criteria† | 3·8 (1·5–9·4) | 0·0046 | 3·1 (1·2–7·9) | 0·0159 |
| <94% or failed SpO2measurement | 7·1 (3·2–15·7) | <0·0001 | 6·6 (2·9–14·7) | <0·0001 |
WHO IMCI referral criteria refers to children with WHO IMCI severe pneumonia. IMCI=Integrated Management of Childhood Illness. SpO2=peripheral oxyhaemoglobin saturation.
*
Risk ratio estimated by Poisson regression with robust variance estimation, and compared with an SpO2 of 94–100%.
†
Any WHO IMCI referral criteria: stridor at rest, convulsions, not feeding or drinking, vomiting everything, lethargy or coma, or severe acute malnutrition (weight-for-age z score less than −3 or a mid-upper arm circumference less than 11·5 cm, or both [for children older than 6 months]).