Imperial College London
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Professor Thomas N Williams

Faculty of Medicine, Department of Surgery & Cancer

Chair in Haemoglobinopathy Research
 
 
 
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Contact

 

tom.williams Website

 
 
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Location

 

Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Connon:2021:10.1186/s12889-021-11481-6,
author = {Connon, R and George, EC and Olupot-Olupot, P and Kiguli, S and Chagaluka, G and Alaroker, F and Opoka, RO and Mpoya, A and Walsh, K and Engoru, C and Nteziyaremye, J and Mallewa, M and Kennedy, N and Nakuya, M and Namayanja, C and Nabawanuka, E and Sennyondo, T and Amorut, D and Williams, Musika C and Bates, I and Boele, van Hensbroek M and Evans, JA and Uyoga, S and Williams, TN and Frost, G and Gibb, DM and Maitland, K and Walker, AS and TRACT, trial group},
doi = {10.1186/s12889-021-11481-6},
journal = {BMC Public Health},
title = {Incidence and predictors of hospital readmission in children presenting with severe anaemia in Uganda and Malawi: a secondary analysis of TRACT trial data},
url = {http://dx.doi.org/10.1186/s12889-021-11481-6},
volume = {21},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Severe anaemia (haemoglobin < 6 g/dL) is a leading cause of recurrent hospitalisation in African children. We investigated predictors of readmission in children hospitalised with severe anaemia in the TRACT trial (ISRCTN84086586) in order to identify potential future interventions. METHODS: Secondary analyses of the trial examined 3894 children from Uganda and Malawi surviving a hospital episode of severe anaemia. Predictors of all-cause readmission within 180 days of discharge were identified using multivariable regression with death as a competing risk. Groups of children with similar characteristics were identified using hierarchical clustering. RESULTS: Of the 3894 survivors 682 (18%) were readmitted; 403 (10%) had ≥2 re-admissions over 180 days. Three main causes of readmission were identified: severe anaemia (n = 456), malaria (n = 252) and haemoglobinuria/dark urine syndrome (n = 165). Overall, factors increasing risk of readmission included HIV-infection (hazard ratio 2.48 (95% CI 1.63-3.78), p < 0.001); ≥2 hospital admissions in the preceding 12 months (1.44(1.19-1.74), p < 0.001); history of transfusion (1.48(1.13-1.93), p = 0.005); and missing ≥1 trial medication dose (proxy for care quality) (1.43 (1.21-1.69), p < 0.001). Children with uncomplicated severe anaemia (Hb 4-6 g/dL and no severity features), who never received a transfusion (per trial protocol) during the initial admission had a substantially lower risk of readmission (0.67(0.47-0.96), p = 0.04). Malaria (among children with no prior history of transfusion) (0.60(0.47-0.76), p < 0.001); younger-age (1.07 (1.03-1.10) per 1 year younger, p < 0.001) and known sickle cell disease (0.62(0.46-0.82), p = 0.001) also decreased risk of readmission. For anaemia re-admissions, gross
AU  - Connon,R
AU  - George,EC
AU  - Olupot-Olupot,P
AU  - Kiguli,S
AU  - Chagaluka,G
AU  - Alaroker,F
AU  - Opoka,RO
AU  - Mpoya,A
AU  - Walsh,K
AU  - Engoru,C
AU  - Nteziyaremye,J
AU  - Mallewa,M
AU  - Kennedy,N
AU  - Nakuya,M
AU  - Namayanja,C
AU  - Nabawanuka,E
AU  - Sennyondo,T
AU  - Amorut,D
AU  - Williams,Musika C
AU  - Bates,I
AU  - Boele,van Hensbroek M
AU  - Evans,JA
AU  - Uyoga,S
AU  - Williams,TN
AU  - Frost,G
AU  - Gibb,DM
AU  - Maitland,K
AU  - Walker,AS
AU  - TRACT,trial group
DO  - 10.1186/s12889-021-11481-6
PY  - 2021///
SN  - 1471-2458
TI  - Incidence and predictors of hospital readmission in children presenting with severe anaemia in Uganda and Malawi: a secondary analysis of TRACT trial data
T2  - BMC Public Health
UR  - http://dx.doi.org/10.1186/s12889-021-11481-6
UR  - https://www.ncbi.nlm.nih.gov/pubmed/34325680
UR  - http://hdl.handle.net/10044/1/90972
VL  - 21
ER  -
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