دورية أكاديمية
Mid-upper arm circumference predicts death in adult patients admitted to a TB ward in the Philippines: a prospective cohort study
| العنوان: | Mid-upper arm circumference predicts death in adult patients admitted to a TB ward in the Philippines: a prospective cohort study |
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| المؤلفون: | Lee, N, White, LV, Marin, FP, Saludar, NR, Solante, MB, Tactacan-Abrenica, RJC, Calapis, RW, Suzuki, M, Saito, N, Ariyoshi, K, Parry, CM, Edwards, T, Cox, SE |
| بيانات النشر: | Public Library of Science |
| سنة النشر: | 2021 |
| المجموعة: | Oxford University Research Archive (ORA) |
| الوصف: | BACKGROUND: The Philippines is ranked 3rd globally for tuberculosis incidence (554/100,000 population). The tuberculosis ward at San Lazaro Hospital, Manila receives 1,800-2,000 admissions of acutely unwell patients per year with high mortality. Objectives of this prospective cohort study were to quantify the association of under-nutrition (primary) and diabetes (secondary) with inpatient mortality occurring between 3-28 days of hospital admission in patients with suspected or previously diagnosed TB. METHODS AND RESULTS: We enrolled 360 adults (≥18 years); 348 were eligible for the primary analysis (alive on day 3). Clinical, laboratory, anthropometric and enhanced tuberculosis diagnostic data were collected at admission with telephone tracing for mortality up to 6 months post-discharge. In the primary analysis population (mean age 45 years, SD = 15.0 years, 70% male), 58 (16.7%) deaths occurred between day 3-28 of admission; 70 (20.1%) between day 3 and discharge and documented total post-day 3 mortality including follow-up was 96 (27.6%). In those in whom it could be assessed, body mass index (BMI) ranged from 11.2-30.6 kg/m2 and 141/303 (46.5%) had moderate/severe undernutrition (BMI<17 kg/m2). A sex-specific cut-off for mid-upper arm circumference predictive of BMI<17 kg/m2 was associated with inpatient Day 3-28 mortality in males (AOR = 5.04, 95% CI: 1.50-16.86; p = 0.009; p = 0.032 for interaction by sex). The inability to stand for weight/height for BMI assessment was also associated with mortality (AOR = 5.59; 95% CI 2.25-13.89; p<0.001) as was severe compared to normal/mild anaemia (AOR = 9.67; 95% CI 2.48-37.76; p<0.001). No TB specific variables were associated with Day 3-28 mortality, nor was diabetes (HbA1c ≥6.5% or diabetes treatment). Similar effects were observed when the same multivariable model was applied to confirmed TB patients only and to the outcome of all post-day 3 in-patient mortality. CONCLUSION: This research supports the use of mid-upper arm circumference for triaging ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | https://ora.ox.ac.uk/objects/uuid:c383e16c-72a6-4927-be84-6ba142cd44b3Test; https://doi.org/10.1371/journal.pone.0218193Test |
| DOI: | 10.1371/journal.pone.0218193 |
| الإتاحة: | https://doi.org/10.1371/journal.pone.0218193Test https://ora.ox.ac.uk/objects/uuid:c383e16c-72a6-4927-be84-6ba142cd44b3Test |
| حقوق: | info:eu-repo/semantics/openAccess ; CC Attribution (CC BY) |
| رقم الانضمام: | edsbas.4DC412DD |
| قاعدة البيانات: | BASE |
| DOI: | 10.1371/journal.pone.0218193 |
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