Observational studyBMJ paediatrics open2026
Predictors of postdischarge mortality among hospitalised children aged 5-14 years at tertiary hospitals in Tanzania: a prospective observational cohort study.
Observational study in BMJ paediatrics open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionPostdischarge mortality is an important but under-recognised outcome in paediatric care, particularly in resource-limited settings where reported rates vary widely.
objectivesTo determine the proportion of postdischarge mortality and its predictors among children aged 5-14 years admitted to paediatric wards at Muhimbili National Hospital (MNH), Jakaya Kikwete Cardiac Institute (JKCI) and Muhimbili Orthopedic Institute (MOI). METHODS AND ANALYSIS: A prospective cohort study was conducted over 10 months among children aged 5-14 years admitted to paediatric wards at MNH, JKCI and MOI. Data were collected using a structured questionnaire. Participants were followed up by telephone at 1, 2 and 3 months after discharge. IBM SPSS Statistics V.25 was used for data analysis. Cox proportional hazards regression was used to identify factors associated with postdischarge mortality at a 5% significance level, and survival was estimated using Kaplan-Meier methods. Verbal autopsy was conducted to determine probable causes of death.
resultsA total of 786 participants were enrolled in the study. The median age of the participants was 7 years (IQR 5-9 years). 467 (59.4%) were male. During the 3-month follow-up, 22 of 744 (2.9%) participants with known postdischarge outcomes died.Factors associated with postdischarge mortality included HIV infection (HR 9.83, 95% CI 2.3 to 41.5), chronic kidney disease (HR 18.26, 95% CI 1.3 to 39.26), duration of symptoms >2 weeks (HR 4.7, 95% CI 1.5 to 14.73), leukocytosis (HR 7.94, 95% CI 1.97 to 32.03) and discharge against medical advice (HR 55.4, 95% CI 4.46 to 393.11).More than half of the deaths occurred within the first month after discharge, and 13 (59.1%) occurred at home. The most common probable causes were pneumonia and malignancies, each accounting for 18.2% of deaths.
conclusionPostdischarge mortality was relatively low but higher in patients with chronic conditions and those discharged against medical advice. Most deaths occurred within the first month. CLINICAL TRIAL NUMBER: Not applicable.
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