Patient selection: children from 12 to 59 months of age
Parameters from multivariate logistic regression analysis:
(1) mid upper arm circumference in cm (MUAC)
(2) weight for height z score (WHZ) for age and gender
(3) gross physical appearance of wasting (wasting of the gluteal area; presence of bony prominence over the chest wall)
|
Parameter
|
Finding
|
Points
|
|
mid upper arm circumference
|
> 11.5 cm
|
0
|
|
|
<= 11.5 cm
|
1
|
|
weight for height z score
|
> -3.0
|
0
|
|
|
<= -3.0
|
1
|
|
physical wasting
|
none to moderate
|
0
|
|
|
severe
|
1
|
total number of risk factors =
= SUM(points for all 3 factors)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 3
• The presence of risk factors is associated with an increased risk for inpatient mortality.
Performance:
• The tests depend on appropriate training of the observer(s). The mid-upper arm circumference must be taken at a standard point with a nonstretchable tape.
• The sensitivity of MUAC for inpatient mortality was 46% with specificity of 91%. The adjusted odds ratio was 1.8.
• The sensitivity of WHZ for inpatient mortality was 42% with specificity of 92%. The adjusted odds ratio was 2.6.
• The sensitivity of severe wasting for inpatient mortality was 47% with specificity of 93%. The adjusted odds ratio was 4.8.
