Table 2.
Hypoxemia prevalence and quality of oxygen provision for hospitalized Malawian children by primary hospital diagnosis
| Primary hospital diagnosis
|
Overall total |
p value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Respiratory
|
Non-respiratory
|
|||||||||||||
| Pneumonia
|
Other | Total | Malariaa | Sepsis | Severe acute malnutrition |
Severe anemia |
Gastro- enteritisb |
Other | Total | |||||
| Non-severe | Severe | Very severe | ||||||||||||
| No. | 13 | 113 | 25 | 8 | 159 | 427 | 29 | 19 | 31 | 29 | 67 | 602 | 761 | |
| Characteristic | ||||||||||||||
| SpO2 [median (IQR)] | 98.0 (97.0–99.0) | 96.5 (93.5–98.5) | 93.0 (88.0–97.0) | 95.5 (94.0–97.0) | 96.5 (93.0–98.5) | 99.0 (97.5–99.5) | 98.5 (97.5–99.0) | 98.5 (97.0–100.0) | 99.0 (98.0–100.0) | 98.5 (98.0–99.5) | 99.5 (98.5–100.0) | 99.0 (97.5–99.5) | 98.5 (97.0–99.5) | <0.001 |
| SpO2 <90% [n/N (%, 95% CI)] | 2/13 (15.4, 3.1– 43.5) | 17/113 (15.0, 9.5– 22.9) | 7/25 (28.0, 14.1– 47.8) | 1/8 (12.5, 0.1– 49.2) | 27/159 (17.0, 11.9– 23.6) | 8/427 (1.9, 0.9– 3.7) | 1/29 (3.4, <0.01– 18.6) | 1/19 (5.3, <0.01– 26.5) | 1/31 (3.2, <0.01– 17.6) | 0/29 (0.0, 0.0– 13.9) | 2/67 (3.0, 0.2– 10.9) | 13/602 (2.2, 1.2– 3.7) | 40/761 (5.3, 3.9– 7.1) | <0.001 |
| Oxygen eligible per WHO clinical criteriac [n/N (%)] | 4/12 (33.3) | 16/105 (15.2) | 23/23 (100.0) | 0/5 | 43/145 (29.7) | 50/341 (14.7) | 2/25 (8.0) | 4/17 (23.5) | 7/25 (28.0) | 3/25 (12.0) | 5/34 (14.7) | 71/467 (15.2) | 114/612 (18.6) | <0.001 |
| Mortality [n/N (%)] | 0/13 | 2/113 (1.8) | 3/25 (12.0) | 1/8 (12.5) | 6/159 (3.8) | 20/427 (4.7) | 3/29 (10.3) | 5/19 (26.3) | 1/31 (3.2) | 0/29 | 6/67 (9.0) | 35/602 (5.8) | 41/761 (5.4) | NS |
| Mortality and SpO2 <90% [n/N (%)] | 0/0 | 1/2 (50.0) | 1/3 (33.3) | 1/1 (100.0) | 3/6 (50.0) | 2/20 (10.0) | 0/3 | 1/5 (20.0) | 1/1 (100.0) | 0/0 | 1/6 (16.7) | 5/35 (14.3) | 8/41 (19.5) | NS |
| Indicators for quality of oxygen care [n/N (%)] | ||||||||||||||
| Obtained admission pulse oximetry reading | 0/13 | 5/113 (4.4) | 1/25 (4.0) | 1/8 (12.5) | 7/159 (4.4) | 10/427 (2.3) | 2/29 (6.9) | 0/19 | 1/31 (3.2) | 0/29 | 0/67 | 13/60 (2.2) | 20/761 (2.6) | NS |
| Correctly prescribed oxygen per WHO clinical criteriad | 0/4 | 1/16 (6.3) | 15/23 (65.2) | 0/0 | 16/43 (37.2) | 8/50 (16.0) | 0/2 | 1/4 (25.0) | 0/7 | 0/3 | 0/5 | 9/71 (12.7) | 25/114 (21.9) | 0.002 |
| Correctly prescribed oxygen per SpO2 <90% | 0/2 | 0/17 | 7/7 (100.0) | 0/1 | 7/27 (25.9) | 2/8 (25.0) | 0/1 | 0/1 | 0/1 | 0/0 | 0/2 | 2/13 (15.4) | 9/40 (22.5) | NS |
NS: not significant; SpO2: peripheral oxygen saturation.
a
6 and 8 patients were assigned a secondary diagnosis of pneumonia and severe pneumonia, respectively.
b
1 patient was assigned a secondary diagnosis of pneumonia.
c
WHO clinical criteria for children <5 years old includes any of the following: very severe pneumonia, central cyanosis, unable to drink, severe lower chest wall indrawing, respiratory rate ≥70 breaths per min, grunting in infants <2 months old or head nodding.
d
According to study staff.