ABSTRACT Background: Complicated severe acute malnutrition (SAM) poses an enormous threat to the survival of children. However, the relationship between admission characteristics and recovery, weight gain and the risk of mortality in children with complicated SAM is limited in Ghana, especially those <6 months old. This study aimed at investigating the treatment outcomes and determinants of mortality in children aged 0–59 months with complicated SAM. Methods: A review of records of children, 0–59 months treated for complicated SAM between January 2013 and June 2017 in two hospitals in Ghana was conducted. Results: Discharge, death and abscond rates were 77.7%, 17.7% and 3.8%, respectively. Median time to death was 5.0 days (IQR: 2.0; 9.0), with infants <6 months dying earlier (1.5 days; 95% CI: 0.7; 3.2, p = 0.001) compared to the 6–59 month group (5.9 days). Shock, convulsion, oedema and HIV-positive status were associated with 7.1 (95% CI: 2.7; 20.5, p < 0.001), 4.2 (95% CI: 1.6; 10.7, p < 0.001), 2.5 (95% CI: 1.2; 5.5, p = 0.02) and 3.1 (95% CI: 1.3; 7.2, p = 0.03) increased odds of death. Conclusion: The high death rate beyond the internationally accepted minimum observed in this study necessitates further research into effective care delivery, appropriate interventions and implementation to reduce SAM deaths in hospitals.

中文翻译：

---

加纳两家转诊医院诊断为复杂性严重急性营养不良的0-59个月大儿童的治疗结果和死亡率决定因素

摘要背景：复杂的严重急性营养不良（SAM）对儿童的生存构成巨大威胁。但是，在加纳，特别是那些小于6个月大的儿童，入院特征与康复，体重增加和死亡风险之间的关系是有限的。本研究旨在调查0-59个月复杂SAM患儿的治疗结果和死亡率决定因素。方法：回顾了2013年1月至2017年6月在加纳的两家医院接受复杂SAM治疗的0-59个月儿童的记录。结果：出院，死亡和潜逃率分别为77.7％，17.7％和3.8％。死亡中位时间为5.0天（IQR：2.0; 9.0），<6个月婴儿死于更早（1.5天; 95％CI：0.7; 3.2，p = 0）。001）与6-59个月组（5.9天）相比。休克，惊厥，水肿和HIV阳性状态分别与7.1（95％CI：2.7; 20.5，p <0.001），4.2（95％CI：1.6; 10.7，p <0.001），2.5（95％CI：1.2）相关； 5.5，p = 0.02）和3.1（95％CI：1.3； 7.2，p = 0.03）增加了死亡几率。结论：本研究中观察到的高死亡率超过了国际公认的最低要求，因此有必要进一步研究有效的医疗服务，适当的干预措施和实施措施，以减少医院中的SAM死亡。