Evidence mapPaperPMID 39939237Full record

ArticleJournal of pediatric surgery2025

Predicting In-hospital Mortality of Pediatric Surgical Admissions in Central Malawi.

Madhushree Zope, Cyrus Sinai, Wiseman Phiri, Bvumi Tembo, Sella Mpata, Betty Yuggu, Bidali Nzira, Selena An, Amarylis Mapurisa, Jed Nuchtern and 3 more

Abstract read
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Article in Journal of pediatric surgery, 2025. 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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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

13 authors.

Madhushree ZopeUniversity of Alabama at Birmingham - Department of Surgery, 1808 7th Ave S # 503U, Birmingham, AL 35294, USA. Electronic address: mszope@uabmc.edu.
Cyrus SinaiUniversity of North Carolina - Department of Geography and Environment, Carolina Hall, Campus Box 3220, Chapel Hill, NC 27599-3220, USA.
Wiseman PhiriKamuzu Central Hospital, 2QFP+9FH, Lilongwe, Malawi.
Bvumi TemboKamuzu Central Hospital, 2QFP+9FH, Lilongwe, Malawi.
Sella MpataKamuzu Central Hospital, 2QFP+9FH, Lilongwe, Malawi.
Betty YugguKamuzu Central Hospital, 2QFP+9FH, Lilongwe, Malawi.
Bidali NziraKamuzu Central Hospital, 2QFP+9FH, Lilongwe, Malawi.
Selena AnUniversity of North Carolina - Department of Surgery, 101 Manning Drive, Chapel Hill, NC 27599, USA.
Amarylis MapurisaKamuzu Central Hospital, 2QFP+9FH, Lilongwe, Malawi.
Jed NuchternBaylor College of Medicine - Department of Pediatric Surgery, 6701 Fannin St., Suite 1210, Houston, TX 77030, USA.
Anthony CharlesUniversity of North Carolina - Department of Surgery, 101 Manning Drive, Chapel Hill, NC 27599, USA.
Bip NandiKamuzu Central Hospital, 2QFP+9FH, Lilongwe, Malawi; Baylor College of Medicine - Department of Pediatric Surgery, 6701 Fannin St., Suite 1210, Houston, TX 77030, USA.
Lindsey L WolfUniversity of Arkansas Medical Sciences - Division of Pediatric Surgery/Arkansas Children's Hospital, 1 Children's Way, Slot #837, Little Rock, AR 72202, USA.

Funding

Integrated Networks of Scholars in Global Health Research Training (INSIGHT) Program D43TW012274 · UNIVERSITY OF MARYLAND BALTIMORE · 2025 to 2025
$1.4M
FIC NIH HHS D43 TW012274
6 · The paper itself

Abstract

backgroundKamuzu Central Hospital (KCH), a tertiary care facility, serves as 1 of 2 pediatric surgical centers in Malawi, a resource limited country in southeastern Africa. We sought to understand the impact of clinical and access-related factors on in-hospital mortality at KCH.

methodsPediatric surgical admissions (<15 years) to KCH from April 1-December 1, 2023, were retrospectively analyzed. Patients were stratified as neonatal (admitted in the first 30 days of life) and non-neonatal. ArcGIS was used to calculate approximate distances traveled to care and to create district-level choropleth maps. Multivariate logistic regression analyses were conducted to identify relevant patient and pre-admission characteristics predictive of in-hospital mortality.

resultsOf 1044 pediatric surgical admissions, 211 (20.2 %) were neonatal, and 833 (79.8 %) were non-neonatal. In-hospital mortality was 23.8 % (n = 50) for neonatal admissions and 2 % (n = 17) for non-neonatal admissions. Increasing distance from home to KCH (OR = 0.22, p = 0.01) and increasing age (OR = 0.93, p < 0.01) conferred a protective effect on in-hospital mortality for neonatal admissions. For non-neonatal patients, readmission (OR = 4.69, p = 0.02) and high level of care on admission (OR = 14.79, p < 0.001) increased the odds of mortality. A distance effect was not seen in the non-neonatal population.

conclusionsThere is a 12-fold increase of in-hospital mortality among admitted neonates with surgical conditions compared to older children. A protective effect of distance in this group may represent the natural selection of healthier neonates being able to travel from farther distances successfully. Older children who were previously admitted or required higher levels of care were at increased risk of death.

Indexed as

Health Services AccessibilityHospital MortalityPatient AdmissionSurgical Procedures, OperativeAdolescentChildChild, PreschoolFemaleHumansInfantInfant, NewbornMalawiMaleRetrospective StudiesGeospatial analysisLow-resource settingPediatric surgeryPost-operative mortality

Identifiers

PMID39939237
PMCPMC12119235

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.