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Table 2 Relative risks for death for the motives of intubation and other predictors among children requiring endotracheal intubation for severe falciparum malaria in Dakar, Senegal

From: Outcome of life-threatening malaria in African children requiring endotracheal intubation

Indication/Variable

Patients No

Deaths (lethality %)

Crude Relative Risk §

95% CI

P value

Adjusted Relative Risk §

95% CI

P value

Deep coma a

16

2 (12.5)

1

  

1

  

Status epilepticus or decorticate rigidity b

20

8 (40.0)

3.2

0.8 – 13.0

0.07

5.7

1.2 – 27.1

0.03

Decerebrate rigidity c

15

11 (73.3)

5.9

1.5 – 22.2

<0.001

10.7

2.3 – 49.5

< 0.01

Acute lung injury d

4

2 (50.0)

4.0

0.8 – 20.3

0.16

3.6

0.5 – 25.8

0.20

Shock e

15

14 (93.3)

7.5

2.0 – 27.5

<0.001

19.3

4.3 – 87.5

<0.001

Thrombocytopaenia

        

   ≥ 100,000/mm3

26

9 (34.6)

1

  

1

  

   < 100,000/mm3

42

27 (64.3)

1.9

1.0 – 3.3

0.01

2.6

1.2 – 5.8

0.01

Second line anticonvulsants f

        

No

36

25 (69.4)

1

  

1

  

Yes

34

12 (35.3)

0.5

0.3 – .8

< 0.01

0.4

0.2 – 0.9

0.02

Respiratory distress g

        

No

26

11 (42.3)

1

     

Yes

44

26 (59.1)

1.4

0.8 – 2.3

0.17

   

Jaundice h

        

No

48

22 (45.8)

1

     

Yes

22

15 (68.2)

1.5

1.0 – 2.3

0.08

   

Hypoglycaemia

        

No

51

22 (43.1)

1

     

Yes

19

15 (78.9)

1.8

1.2 – 2.7

< 0.01

   

Severe anaemia j

        

No

55

26 (47.3)

1

     

Yes

15

11 (73.3)

1.5

1.0 – 2.3

0.07

   

Abnormal bleeding h

        

No

62

30 (48.4)

1

     

Yes

8

7 (87.5)

1.8

1.2 – 2.6

0.06

   

Renal failure k

        

No

68

35 (51.5)

1

     

Yes

2

2 (100)

1.9

1.5 – 2.5

0.49

   

Community-acquired infections l

        

No

58

29 (50.0)

1

     

Yes

12

8 (66.6)

1.3

0.8 – 2.1

0.29

   

Malnutrition m

        

No

44

28 (63.6)

1

     

Yes

26

9 (34.6)

0.5

0.3 – 1.0

0.02

   

Severe hyponatremia n

        

No

62

31 (50.0)

1

     

Yes

8

6 (75.0)

1.5

0.9 – 2.4

0.18

   
  1. Definitions : a deep coma : Glasgow coma score (GCS) ≤ 7 or Blantyre coma score (BCS) ≤ 2, no clinically evident status epilepticus, no abnormal posture ; b coma with overt cortical/diencephalic injury as witnessed by persistent clinically evident status epilepticus or flexor (decorticate) posturing; c coma with brainstem involvement as witnessed by extensor or opisthotonic (decerebrate) posturing; d severe respiratory distress with pulmonary infiltrates on X-ray with a ratio PaO2/FiO2 < 300 Torr [40.1 kPa]; e shock defined as a systolic blood pressure <60 or <80 mm Hg in children < than or > than 5 five years, respectively, in addition to the presence of perfusion abnormalities (urine output < 1 ml/kg/hr, GCS < 15, delayed capillary refill);f continuous infusions of clonazepam or thiopenthal;g sustained low chest wall recession or deep acidotic breathing; h clinical criterion; i glucose level < 2.2 mmol/L; j haemoglobin rate < 5 g/dL; k abnormal ratio creatinine/age; l septicaemia, pneumonia, meningitis or dysenteric; m NCHS Growth charts definition, 1976; n sodium<125 mmo/L
  2. § For bivariate and multivariate analysis (n = 70), children with cardiac arrests (n = 13) and children without platelet counts (n = 2) were excluded.