Table 1. Risk of death among participants in the Fluid Expansion as a Supportive Treatment (FEAST) trial with the application of different definitions of paediatric shock to admission data.
| Definition of shock | Mortality among FEAST participants (%) | Absolute risk difference (95% CI) | Estimated annual No of excess deaths in sub-Saharan Africa if boluses given* | ||
|---|---|---|---|---|---|
| Overall (all arms) | Bolus (saline or albumin) | No bolus (control arm) | |||
| FEAST inclusion criteria | |||||
| Total | 297/3141 (10) | 221/2097 (11) | 76/1044 (7) | 3.3% (1.2 to 5.3) | 33 000 |
| With malaria | 144/1795 (8) | 110/1202 (9) | 34/593 (6) | 3.4% (0.9 to 5.9) | 14 500 |
| Without malaria | 146/1330 (11) | 108/884 (12) | 38/446 (9) | 3.7% (0.3 to 7.1) | 16 000 |
| WHO Emergency Triage Assessment and Treatment | |||||
| Total | 27/65 (42) | 24/50 (48) | 3/15 (20) | 28% (3 to 53) | 1 800 |
| With malaria | 14/41 (34) | 12/32 (37) | 2/9 (22) | 15% (−16 to 47) | 1 300 |
| Without malaria | 11/22 (50) | 11/17 (65) | 0/5 (0) | 65% (42 to 87) | 3 100 |
| American College of Critical Care Medicine cold shock (with two signs) | |||||
| Total | 189/1733 (11) | 147/1196 (12.3) | 42/537 (8) | 4.5% (1.5 to 7.4) | 14 300 |
| With malaria | 95/1087 (9) | 76/753 (10) | 19/334 (6) | 4.4% (1.1 to 7.7); | 8 900 |
| Without malaria | 92/637 (14) | 70/435 (16) | 22/202 (11) | 5.2% (−0.3 to 10.7) | 9 900 |
| Paediatric Advanced Life Support (2010) compensated shock | |||||
| Total | 218/1650 (13) | 161/1113 (15) | 57/537 (11) | 3.9% (0.5 to 7.2) | 26 300 |
| With malaria | 107/1009 (11) | 80/684 (12) | 27/325 (8) | 3.4% (−0.4 to 7.2) | 12 000 |
| Without malaria | 104/628 (17) | 78/421 (19) | 26/207 (13) | 6.0% (0.1 to 11.8) | 11 300 |
Per 1 million paediatric admissions with shock, using relative increase of 1.45 from overall trial result.
NB: There are 16 children with missing malaria results who are not included in the with/without malaria calculations.
FEAST criteria: History of fever or axillary temperature >37.4°C or <36°C with impaired consciousness (prostration or coma) or respiratory distress. plus ≥1 of the following: capillary refill time >2 s, lower limb temperature gradient, weak pulse, tachycardia (heart rate >180 (<12 months), >160 (12 months-5 years), >140 (>5 years)).
WHO Emergency Triage Assessment Treatment criteria: The presence of cold hands or feet with capillary refill time longer than 3 seconds and a weak, fast pulse. ACCM cold shock (with two signs): Axillary temperature >37.4°C or <36°C) plus ≥2 of: prostration/coma or Blantyre coma score <5, capillary refill time >2 s, weak pulse, increased temperature gradient.
PALS (2010) compensated shock: Two of the following: tachycardia (see FEAST criteria for definition), increased temperature gradient, capillary refill time >2 s, weak pulse.