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Table 2 Predictors of readmission

From: Incidence and predictors of hospital readmission in children presenting with severe anaemia in Uganda and Malawi: a secondary analysis of TRACT trial data

Predictor Readmitted (N = 682, col % or median (IQR)) Not readmitted (N = 3212, col % or median (IQR)) Univariate SHR (95% CI) Multivariate SHR (95% CI) p value
Sitea - Mbale 278 (41%) 1203 (37%) 1.00 1.00 0.25
 Blantyre 53 (8%) 402 (13%) 0.61 (0.45–0.82) 0.80 (0.57–1.12)  
 Mulago 136 (20%) 776 (24%) 0.79 (0.65–0.97) 0.82 (0.65–1.03)  
 Soroti 215 (32%) 831 (26%) 1.08 (0.90–1.29) 0.97 (0.79–1.19)  
Age at primary admission (per year younger)a 38.0 (17.0, 60.0) 34.0 (17.0, 62.0) 1.01 (0.98–1.03) 1.07 (1.03–1.10) < 0.001
HIV positivea 26 (4%) 81 (3%) 1.52 (1.02–2.28) 2.48 (1.63–3.78) < 0.001
Sickle status - AA 458 (67%) 2243 (70%) 1.00 1.00 0.01
 AS 25 (4%) 99 (3%) 1.23 (0.82–1.84) 1.16 (0.75–1.81)  
 SS, unknown at discharge 122 (18%) 486 (15%) 1.15 (0.94–1.39) 0.95 (0.76–1.20)  
 SS, known at discharge 73 (11%) 353 (11%) 0.98 (0.77–1.25) 0.62 (0.46–0.82)  
Two or more hospital admissions in the last year before primary admissiona 250 (37%) 651 (20%) 2.05 (1.76–2.40) 1.44 (1.19–1.74) < 0.001
Received blood transfusion ever, prior to this illnessa 341 (50%) 939 (29%) 2.17 (1.87–2.52) 1.48 (1.13–1.93) 0.005
History of cough at primary admissiona 459 (67%) 1973 (61%) 1.27 (1.08–1.49) 1.13 (0.95–1.35) 0.16
Indrawing on admissiona 118 (17%) 378 (12%) 1.51 (1.24–1.84) 1.36 (1.09–1.71) 0.01
Splenomegaly on admissiona - Not palpable 363 (53%) 2132 (66%) 1.00 1.00 0.01
 Enlarged 248 (36%) 884 (28%) 1.57 (1.33–1.84) 1.26 (1.06–1.50)  
 Gross 71 (10%) 190 (6%) 2.02 (1.57–2.61) 1.47 (1.10–1.97)  
Diarrhoea on admission 68 (10%) 437 (14%) 0.72 (0.56–0.92) 0.71 (0.54–0.93) 0.01
Received oral antimalarials in last week before primary admission 359 (53%) 1529 (48%) 1.21 (1.04–1.41) 1.08 (0.92–1.27) 0.36
Malaria positive at primary admission, no previous blood transfusion 195 (29%) 1533 (48%) 0.65 (0.52–0.81) 0.60 (0.47–0.76) < 0.001
Malaria positive at primary admission, previous blood transfusion 209 (31%) 539 (17%) 1.73 (1.40–2.14) 1.58 (1.22–2.04) < 0.001
Randomised > 24 h after admissiona 37 (5%) 131 (4%) 1.28 (0.92–1.77) 1.36 (0.96–1.93) 0.08
Strataa - TRACT A 452 (66%) 1884 (59%) 1.00 1.00 0.14
TRACT B, immediate transfusion 122 (18%) 655 (20%) 0.78 (0.64–0.95) 0.93 (0.74–1.17)  
TRACT B, triggered transfusion 69 (10%) 312 (10%) 0.91 (0.71–1.17) 1.05 (0.79–1.40)  
TRACT B, no transfusion 39 (6%) 361 (11%) 0.48 (0.35–0.67) 0.67 (0.47–0.96)  
Blood pack age (per week older)a 12.0 (7.0, 20.0) 12.0 (7.0, 17.0) 1.10 (1.03–1.18) 1.07 (0.99–1.15) 0.08
Length of stay (per day longer)a 3.0 (2.0, 5.0) 3.0 (2.0, 4.0) 1.05 (1.03–1.07) 1.03 (1.00–1.06) 0.04
Missed dose of MVMM, iron folate or cotrimoxazole by 28 days 245 (36%) 925 (29%) 1.35 (1.15–1.58) 1.43 (1.21–1.69) < 0.001
  1. aselected by initial backwards elimination: retained in final model regardless of significance for control of confounding
  2. Note: Denominators based on children with observed data; numbers missing are given in Supplementary Table 1. Site and receipt of transfusion were included in all models. Final model included 3384/3894 (87%) children discharged alive and 609/682 (89%) readmitted children (exclusions due to missing data). All continuous factors were selected as linear. SHR = sub-hazard ratio from competing risks model (treating death before readmission as a competing risk). TRACT A = severe complicated anaemia (randomised to 30 vs 20 mls/kg transfusion). TRACT B = severe uncomplicated anaemia (randomised to immediate transfusion vs triggered transfusion; those who ultimately received a transfusion are labelled “triggered transfusion” and those who did not “no transfusion”)