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Cited by 144Global Maternal and Child HealthChild Nutrition and Water AccessPneumonia and Respiratory Infections

The DOI matches its Crossref record; 23 of the 23 references it cites were found in a registry or an index.

Pediatric Post-Discharge Mortality in Resource Poor Countries: A Systematic Review

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Wiens, Matthew O., Pawluk, Shane, Kissoon, Niranjan, Kumbakumba, Elias, Ansermino, J. Mark, Singer, Joel, Ndamira, Andrew, Larson, Charles·2013·PLoS ONE
DOI 10.1371/journal.pone.0066698PMC PMC3692523
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Abstract

OBJECTIVES: Mortality following hospital discharge is an important and under-recognized contributor to overall child mortality in developing countries. The primary objective of this systematic review was to identify all studies reporting post-discharge mortality in children, estimate likelihood of death, and determine the most important risk factors for death. SEARCH STRATEGY: MEDLINE and EMBASE were systematically searched using MeSH terms and keywords from the inception date to October, 2012. Key word searches using Google Scholar™ and hand searching of references of retrieved articles was also performed. Studies from developing countries reporting mortality following hospital discharge among a pediatric population were considered for inclusion. RESULTS: Thirteen studies that reported mortality rates following discharge were identified. Studies varied significantly according to design, underlying characteristics of study population and duration of follow-up. Mortality rates following discharge varied significantly between studies (1%-18%). When reported, post-discharge mortality rates often exceeded in-hospital mortality rates. The most important baseline variables associated with post-discharge mortality were young age, malnutrition, multiple previous hospitalizations, HIV infection and pneumonia. Most post-discharge deaths occurred early during the post-discharge period. Follow-up care was examined in only one study examining malaria prophylaxis in children discharged following an admission secondary to malaria, which showed no significant benefit on post-discharge mortality. CONCLUSIONS: The months following hospital discharge carry significant risk for morbidity and mortality. While several characteristics are strongly associated with post-discharge mortality, no validated tools are available to aid health workers or policy makers in the systematic identification of children at high risk of post-discharge mortality. Future research must focus on both the creation of tools to aid in defining groups of children most likely to benefit from post-discharge interventions, and formal assessment of the effectiveness of such interventions in reducing morbidity and mortality in the first few months following hospital discharge.

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Figure 1 Flow diagram of the search for identifying and selecting studies of post-discharge mortality.
Figure 1 Flow diagram of the search for identifying and selecting studies of post-discharge mortality.CC BY · PubMed Central

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Metadata

Authors
Wiens, M. O., Pawluk, S., Kissoon, N., Kumbakumba, E., Ansermino, J. M., Singer, J., Ndamira, A., & Larson, C.
Affiliations
  • Mbarara University of Science and Technology (UG)
  • University of British Columbia (CA)
Corresponding author
Wiens, Matthew O.
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2013-06-25
Volume
8
Issue
6
Pages
e66698
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0066698
PMC
PMC3692523
OpenAlex
W2073569962
Cited by
144
References
23
Citations by year
2026: 4 · 2025: 12 · 2024: 17 · 2023: 14 · 2022: 15 · 2021: 22 · 2020: 9 · 2019: 16 · 2018: 11 · 2017: 8 · 2016: 8 · 2015: 6 · 2014: 1
FWCI
0.71
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Canadian Child Health Clinician Scientist Program
  • Michael Smith Health Research BC
  • Canadian Institutes of Health Research
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
  • Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
Keywords
post-discharge mortality, child mortality, resource-poor countries, mortality risk factors, malnutrition, HIV infection, pneumonia, malaria prophylaxis, follow-up care, hospital discharge
MeSH terms
Child, Developing Countries, Health Resources, Humans, Mortality, Patient Admission, Patient Discharge

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