Table 7. Summary of Previous Studies Examining Risk Factors for Death in Patients with Shigellosis.
| Study Author, Reference | Country | Study Date | Age of Patients | Patients, n | Deaths, n (%) | Shigella Species | Predictors of Death | Odds ratio | Comment |
| Bennish [16] | Bangladesh | 1983 | ≤10 years | 201 | 67 (34) | 23% S. dysenteriae type 1,4% S. dysenteriae type 2–10,62% S. Flexneri, 6% S.boydii, 5% S. sonnei | Age in months | 0.969 | Case-control study conducted in hospitalized patients in an urban area |
| Serum protein (g/l) | 0.945 | ||||||||
| Altered consciousness | 4.80 | ||||||||
| Thrombocytopenia | 9.29 | ||||||||
| Mitra [34] | Bangladesh | 1980 | ≤5 years | 46 | 23 (50) | Not recorded | Female | 4.30 | Case-control study conducted in hospitalized patients in a rural area |
| Signs of lower respiratory infection | 24.0 | ||||||||
| Severe malnutrition (<60% of weight for age) | 8.90 | ||||||||
| Huskins [20] | Bangladesh | 1984–1988 | ≤3 months | 121 | 26 (21) | 9% S. dysenteriae type 1,3% S. dysenteriae type 2–10,59% S. flexneri, 21% S. boydii,8% S. sonnei | Gram-negative bacteremia | 14.61 | Prospective study of infants and young children in an urban hospital. Study patients were a subset of patients in the current study |
| Ileus | 93.83 | ||||||||
| Decreased bowel sounds | 86.81 | ||||||||
| Serum sodium (mmol/L) | 0.884 | ||||||||
| Serum protein concentration (g//L) | 0.819 | ||||||||
| Number of erythrocytes on stool microscopic examination (high power field) | 0.931 | ||||||||
| Nathoo [32] | Ziwakhanmbabwe | 1993–1994 | 1 month to 12 years | 312 | 95 (30) | 100% S. dysenteriae type 1 | Temperature (<36.0°C) | 2.12 | Study conducted in two urban tertiary referral hospitals. Data from 264 patients collected prospectively; data on 48 patients collectedRetrospectively |
| Severe dehydration | 1.70 | ||||||||
| Serum sodium (<120 mmol/L) | 1.57 | ||||||||
| Serum potassium (>5.5 mmol/L) | 1.41 | ||||||||
| Urea (>8 mmol/L) | 1.74 | ||||||||
| Abdominal distention | 1.67 | ||||||||
| Legros [31] | Rwanda | 1994 | All ages | 849 | 108 (13) | 100% S. dysenteriae type 1 | Severe dehydration | 2.79 | Prospective study conducted in 10 rural hospitals |
| Pedal edema | 2.20 | ||||||||
| Age (<5 years or >50 years) | 3.22 | ||||||||
| Use of nalidixic acid | 8.66 | ||||||||
| Van den Broek [33] | Bangladesh | 1993–1999 | ≤4 years | 200 | 100 (50) | 19% S. dysenteriae type 1, 81% S. flexneri | Altered consciousness | 2.60 | Case control study in urban hospital restricted to malnourished children (<60% of median weight-for- age) |
| Pneumonia | 2.50 | ||||||||
| Hypoglycemia (<3 mmol/L) | 7.80 | ||||||||
| Temperature (<36.0°C) | 5.70 | ||||||||
| Khan, this study | Bangladesh | 1987–1988 | <15 years | 792 | 83 (10) | 20% S. dysenteriae type 1, 3% S. dysenteriae type 2–10, 63% S. Flexneri, 10% S. boydii, 4% S. sonnei | Age, m | 0.966 | Prospective study in an urban hospital |
| Number. of stools before admission | 0.976 | ||||||||
| Percent of median weight-for-age | 0.957 | ||||||||
| Serum sodium, (<126 µmol/l) | 3.75 | ||||||||
| Convulsion | 14.60 | ||||||||
| Unconsciousness | 45.40 |
All studies used multivariate logistic regression analysis to determine factors predictive of death with the exception of Mitra (reference 34), which used bivariate analysis.