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Table 3 Predictors of readmission for specified causes

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 Anaemia SHR (95% CI) p Malaria SHR (95% CI) p Heterogeneity of effect between anaemia and malaria DUS SHR (95% CI) p value
Site* - Mbale 1.00 < 0.001 1.00 0.99 0.09 1.00 < 0.001
 Blantyre 0.68 (0.44–1.04)   0.91 (0.44–1.85)     
 Mulago 0.56 (0.42–0.75)   0.95 (0.57–1.56)    0.14 (0.06–0.34)**  
 Soroti 0.68 (0.53–0.88)   1.01 (0.69–1.48)    0.91 (0.57–1.47)  
Age at primary admission (per year younger)* 1.03 (0.99–1.07) 0.12 1.15 (1.07–1.23) < 0.001 0.003 0.98 (0.91–1.06) 0.69
HIV positive* 2.48 (1.52–4.04) < 0.001 0.85 (0.26–2.76) 0.79 0.05
Sickle status* - AA 1.00 < 0.001 1.00 0.24 0.48 1.00 0.01
 AS 1.28 (0.77–2.14)   0.84 (0.34–2.05)    1.18 (0.45–3.11)  
 SS, unknown at discharge 0.95 (0.72–1.26)   0.77 (0.44–1.36)    0.06 (0.01–0.41)  
 SS, known at discharge 0.43 (0.30–0.64)   0.51 (0.26–1.00)    0.43 (0.20–0.95)  
Two or more hospital admissions in the last year before primary admission* 1.67 (1.33–2.11) < 0.001 1.24 (0.88–1.74) 0.22 0.31 2.52 (1.63–3.91) < 0.001
Received blood transfusion ever, prior to this illness* 1.67 (1.21–2.32) 0.002 2.19 (1.19–4.05) 0.01 0.50 2.74 (0.94–7.95) 0.06
History of cough at primary admission* 1.07 (0.87–1.33) 0.51 1.12 (0.82–1.52) 0.49 0.94 1.21 (0.80–1.83) 0.36
Indrawing on primary admission* 1.09 (0.82–1.44) 0.57 1.27 (0.83–1.94) 0.28 0.37 1.16 (0.66–2.03) 0.60
Splenomegaly on admission* - Not palpable 1.00 < 0.001 1.00 0.57 0.14 1.00 0.43
 Enlarged 1.46 (1.18–1.82)   1.19 (0.87–1.63)    1.21 (0.76–1.94)  
 Gross 1.73 (1.23–2.44)   1.14 (0.64–2.04)    0.82 (0.40–1.71)  
Diarrhoea on primary admission 0.73 (0.52–1.02) 0.07 0.72 (0.42–1.22) 0.22 0.79 0.57 (0.27–1.20) 0.14
Received oral antimalarials in last week before primary admission* 1.25 (1.02–1.53) 0.03 0.95 (0.71–1.27) 0.71 0.04 1.19 (0.82–1.73) 0.36
Malaria positive at primary admission, no previous blood transfusion 0.56 (0.41–0.77) < 0.001 1.33 (0.77–2.32) 0.31 0.002 1.71 (0.66–4.43) 0.27
Malaria positive at primary admission, previous blood transfusion 1.52 (1.10–2.09) 0.02 2.61 (1.50–4.53) 0.74 0.07 4.48 (1.70–11.77) 0.94
Randomised > 24 h after admission* 1.49 (0.97–2.29) 0.07 0.91 (0.46–1.81) 0.79 0.09 1.70 (0.83–3.45) 0.14
Strata* - TRACT A 1.00 0.29 1.00 0.08 0.003 1.00 0.47
 TRACT B, immediate transfusion 0.88 (0.64–1.21)   1.14 (0.76–1.71)    1.39 (0.80–2.41)  
 TRACT B, triggered transfusion 1.12 (0.78–1.63)   1.59 (0.97–2.59)    1.31 (0.64–2.65)  
 TRACT B, no transfusion 0.68 (0.41–1.11)   0.66 (0.33–1.31)     
Blood pack age (per week older)* 1.09 (1.00–1.18) 0.05 1.09 (0.96–1.24) 0.18 0.81 0.98 (0.83–1.15) 0.81
Length of stay (per day longer) 1.02 (0.98–1.05) 0.38 1.02 (0.97–1.08) 0.41 0.76 1.02 (0.95–1.10) 0.60
Missed dose of MVMM, iron folate or cotrimoxazole by 28 days* 1.34 (1.09–1.64) 0.005 1.25 (0.92–1.69) 0.16 0.34 1.67 (1.16–2.40) 0.01
Admitted > 24 h into another hospital at primary admission 0.74 (0.55–1.01) 0.06    0.74   
Haemoglobin at admission (per g/dL lower) 1.16 (1.05–1.29 0.01    0.83   
Type of homestead - Urban    1.00 0.002 0.0031   
 Semi urban    0.46 (0.15–1.42)     
 Rural    2.19 (0.99–4.84)     
Able to walk unaided before this illness at primary admission    1.79 (1.01–3.20) 0.05 0.042   
Temperature gradient at primary admission    2.07 (1.28–3.35) 0.003 0.0033   
Cotrimoxazole randomisation- cotrimoxazole (vs no cotrimoxazole)    0.75 (0.57–1.00) 0.05 0.044   
Monocytes (per 109/L) at admission    0.87 (0.77–0.99) 0.03 0.035   
Platelets (per 100 × 109/L) at admission    1.10 (1.02–1.20) 0.02 0.11   
Blood pack type- settled (vs whole)    0.70 (0.49–1.00) 0.05 0.07   
Haemoglobinuria in this illness at primary admission       2.26 (1.37–3.71) 0.001
Liver > 2 cm below costal margin       1.47 (0.92–2.38) 0.11
Positive blood culture at primary admission       3.25 (1.42–7.46) 0.01
Granulocytes (per 10 × 109/L) on primary admission       1.35 (1.09–1.66) 0.01
  1. *selected by initial backwards elimination: retained in final model regardless of significance for control of confounding
  2. ** Blantyre and Mulago combined as there were no DUS readmissions in Blantyre
  3. Note: Site and receipt of transfusion are included in all models. Anaemia: including 3381/3894 (87%) children discharged alive and 407/456 (89%) readmitted children (exclusions due to missing data). Malaria: including 3317/3894 (85%) children discharged alive, and 223/252 (88%) readmitted children. DUS: including 2633/3894 (68%) children discharged alive and 121/165 (73%) readmitted children. SHR = sub-hazard ratio from competing risks model (treating death before readmission for the specific cause 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”)
  4. HRs for anaemia readmission from stacked model:
  5. 1Type of homestead: semi urban 0.86 (0.53–1.41); rural 1.01 (0.66–1.54)
  6. 2Able to walk unaided before this illness at primary admission: 0.98 (0.68–1.42)
  7. 3Temperature gradient at primary admission: 1.04 (0.70–1.55)
  8. 4Cotrimoxazole randomisation- cotrimoxazole (vs no cotrimoxazole): 1.03 (0.83–1.27)
  9. 5Monocytes (per 109/L) at admission: 1.02 (0.94–1.11)