{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Wiens MO"],"funding":["Grand Challenges Canada","Thrasher Research Fund","BC Children’s Hospital Foundation","Mining4Life"],"pagination":["e0003050"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC11057737"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["4(4)"],"pubmed_abstract":["In many low-income countries, over five percent of hospitalized children die following hospital discharge. The lack of available tools to identify those at risk of post-discharge mortality has limited the ability to make progress towards improving outcomes. We aimed to develop algorithms designed to predict post-discharge mortality among children admitted with suspected sepsis. Four prospective cohort studies of children in two age groups (0-6 and 6-60 months) were conducted between 2012-2021 in six Ugandan hospitals. Prediction models were derived for six-months post-discharge mortality, based on candidate predictors collected at admission, each with a maximum of eight variables, and internally validated using 10-fold cross-validation. 8,810 children were enrolled: 470 (5.3%) died in hospital; 257 (7.7%) and 233 (4.8%) post-discharge deaths occurred in the 0-6-month and 6-60-month age groups, respectively. The primary models had an area under the receiver operating characteristic curve (AUROC) of 0.77 (95%CI 0.74-0.80) for 0-6-month-olds and 0.75 (95%CI 0.72-0.79) for 6-60-month-olds; mean AUROCs among the 10 cross-validation folds were 0.75 and 0.73, respectively. Calibration across risk strata was good: Brier scores were 0.07 and 0.04, respectively. The most important variables included anthropometry and oxygen saturation. Additional variables included: illness duration, jaundice-age interaction, and a bulging fontanelle among 0-6-month-olds; and prior admissions, coma score, temperature, age-respiratory rate interaction, and HIV status among 6-60-month-olds. Simple prediction models at admission with suspected sepsis can identify children at risk of post-discharge mortality. Further external validation is recommended for different contexts. Models can be digitally integrated into existing processes to improve peri-discharge care as children transition from the hospital to the community."],"journal":["PLOS global public health"],"pubmed_title":["Prediction models for post-discharge mortality among under-five children with suspected sepsis in Uganda: A multicohort analysis."],"pmcid":["PMC11057737"],"funding_grant_id":["TTS-1809-1939","13878"],"pubmed_authors":["Olaro C","Bone JN","Novakowski S","West N","Knappett M","Ansermino JM","Barigye C","Larson CP","Byaruhanga E","Nsungwa J","Tagoola A","Lavoie PM","Mugisha NK","Kabakyenga J","Wiens MO","Sherine SO","Nguyen V","Moschovis PP","Tayebwa M","Kumbakumba E","Businge S","Dunsmuir D","Ssemwanga E","Komugisha C","Singer J","Kissoon N","Mwesigwa D"],"additional_accession":[]},"is_claimable":false,"name":"Prediction models for post-discharge mortality among under-five children with suspected sepsis in Uganda: A multicohort analysis.","description":"In many low-income countries, over five percent of hospitalized children die following hospital discharge. The lack of available tools to identify those at risk of post-discharge mortality has limited the ability to make progress towards improving outcomes. We aimed to develop algorithms designed to predict post-discharge mortality among children admitted with suspected sepsis. Four prospective cohort studies of children in two age groups (0-6 and 6-60 months) were conducted between 2012-2021 in six Ugandan hospitals. Prediction models were derived for six-months post-discharge mortality, based on candidate predictors collected at admission, each with a maximum of eight variables, and internally validated using 10-fold cross-validation. 8,810 children were enrolled: 470 (5.3%) died in hospital; 257 (7.7%) and 233 (4.8%) post-discharge deaths occurred in the 0-6-month and 6-60-month age groups, respectively. The primary models had an area under the receiver operating characteristic curve (AUROC) of 0.77 (95%CI 0.74-0.80) for 0-6-month-olds and 0.75 (95%CI 0.72-0.79) for 6-60-month-olds; mean AUROCs among the 10 cross-validation folds were 0.75 and 0.73, respectively. Calibration across risk strata was good: Brier scores were 0.07 and 0.04, respectively. The most important variables included anthropometry and oxygen saturation. Additional variables included: illness duration, jaundice-age interaction, and a bulging fontanelle among 0-6-month-olds; and prior admissions, coma score, temperature, age-respiratory rate interaction, and HIV status among 6-60-month-olds. Simple prediction models at admission with suspected sepsis can identify children at risk of post-discharge mortality. Further external validation is recommended for different contexts. Models can be digitally integrated into existing processes to improve peri-discharge care as children transition from the hospital to the community.","dates":{"release":"2024-01-01T00:00:00Z","publication":"2024","modification":"2026-07-01T03:24:52.109Z","creation":"2026-07-01T03:12:35.574Z"},"accession":"S-EPMC11057737","cross_references":{"pubmed":["38683787"],"doi":["10.1371/journal.pgph.0003050"]}}