Table 1.
Description of Cohorta
| Characteristics | Cohort (n = 180) | In-hospital Mortality (n = 15) | Postdischarge Mortality (n = 8) |
|---|---|---|---|
| Demographics and History | |||
| Age, years | 2.0 (1.0–3.0) | 1.1 (1.0–2.0) | 1.1 (1.0–2.8) |
| Female sex | 78 (43.3) | 7 (53.3) | 5 (62.5) |
| Weight-for-age z-score | −1 (−2, 0) | −1 (−2, 0) | 0 (−2, 1) |
| Height-for-age z-score | −2 (−3, 0) | −2 (−3, 0) | 0 (−2, 1) |
| Weight-for-height z-score | 0 (−1, 1) | −1 (−2, 0) | 0 (−1, 1) |
| Fever before enrollment, days | 3.0 (2.0–4.0) | 3.0 (2.0–4.0) | 2.0 (2.0–2.8) |
| Characteristics at admission | |||
| Temperature, °C | 37.9 (37.0–38.8) | 37.0 (36.6–37.8)† | 37.8 (36.9–39.0) |
| Heart rate, bpm | 162 (144–179) | 173 (156–183) | 156 (155–163) |
| Respiratory rate, bpm | 48 (38–62) | 61 (47–77)† | 55 (40–64) |
| Systolic blood pressure, mmHg | 110 (100–120) | 100 (90–126)† | 120 (120–130)† |
| Blantyre coma score (BCS) | 2 (2–3) | 2 (1–2) | 3 (2–4) |
| Lambaréné Organ Dysfunction Score | 2 (1–3) | 3 (2–3) | 1.5 (0.3–2.0) |
| Prostrate | 164/180 (91.1) | 15/15 (100.0) | 6/8 (75.0) |
| Convulsions >6 h after admission | 32/178 (18.0) | 1/15 (6.7) | 2/8 (25.0) |
| Impaired consciousness | 155/180 (86.1) | 13/15 (86.7) | 5/8 (62.5) |
| Comatose (BCS < 3) | 106/180 (58.9) | 14/15 (93.3)† | 2/8 (25.0) |
| Deep breathing | 86/180 (47.8) | 12/15 (80.0)† | 3/8 (37.5) |
| Severe anemia | 113/179 (63.1) | 13/15 (86.7)† | 8/8 (100.0)† |
| Hemoglobinuria | 33/180 (18.3) | 5/15 (33.3) | 2/8 (25.0) |
| Jaundice | 28/179 (15.6) | 3/15 (20.0) | 3/8 (37.5) |
| Shock | 16/180 (8.9) | 4/15 (26.7)† | 1/8 (12.5) |
| Number of severe malaria Criteriab | 4 (3–6) | 7 (6–7)† | 4 (3–5) |
| Laboratory Results | |||
| Parasitemia (parasites/µL) | 26 720 (2434–84 640) | 6600 (360–108 520) | 1460 (400–46 800)† |
| Hemoglobin (g/dL) | 4.8 (3.2–6.5) | 4.7 (2.8–5.0) | 3.4 (2.6–3.6)† |
| White blood cell count | 11.8 (7.6–19.3) | 10.7 (5.2–20.0) | 18.8 (8.7–24.1) |
| Platelet count | 71 (38–128) | 65 (40–133) | 131 (67–243) |
| Glucose | 6.7 (5.5–8.1) | 6.9 (4.4–7.9) | 6.0 (5.5–11.6) |
| Lactate | 3.6 (2.1–6.4) | 6.6 (3.7–10.6)† | 4.3 (2.5–7.3) |
| Base excess | −8 (−12, −4) | −16 (−19, −12)† | −8 (−11, −5) |
| Creatinine, µmol/L | 32 (23–42) | 39 (23–49) | 28 (24–35) |
| BUN, mg/dL | 16 (10–28) | 28 (18–42)† | 23 (10–43) |
| LDH, mU/mL | 482 (313–699) | 795 (482–1496)† | 716 (529–902)† |
| Outcome | |||
| Mortality | |||
| In-hospital | 15/180 (8.3) | — | — |
| 6 moc | 23/143 (16.1) | — | — |
| Neurologic disability at discharge | 13/163 (8.0) | — | 0/7 (0.0) |
Abbreviations: bpm, beats per minute; BUN, blood urea nitrogen; IQR, interquartile range; LDH, lactate dehydrogenase.
a Data are presented as median (IQR) or n (%).
b Criteria assessed: coma (BCS < 3), repeated seizures (>2 generalized seizures in 24 hours), respiratory distress (age-related tachypnea with sustained nasal flaring, deep breathing, or subcostal retractions), prostration (unable to sit unsupported), acute kidney injury (as described previously [22]), jaundice, hypoglycemia (<2.2 mM), hyperlactatemia (>5 mmol/L), severe anemia (Hb < 5 g/dL), shock.
c Children <5 years were observed for 6 months (n = 19 > 5 years, n = 16 lost to follow up, n = 2 withdrew).
† Indicates P < .05 between in-hospital deaths and surviving children; or post-discharge deaths and children known to survive to 6 months.