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The Power of Pulse Oximetry to Improve Post-Discharge Survival: Matthew Wiens

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The Power of Pulse Oximetry to Improve Post-Discharge Survival: Matthew Wiens

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Pulse oximetry is a tool with multiple applications that could improve diagnosis, treatment and ultimately survival rates among children under 5 in low resource settings. Matthew Wiens from the University of British Columbia describes the power of pulse oximetry to identify and manage children most at risk following discharge from hospital.

Pulse oximetry is a tool with multiple applications that could improve diagnosis, treatment and ultimately survival rates among children under 5 in low resource settings. Matthew Wiens from the University of British Columbia describes the power of pulse oximetry to identify and manage children most at risk following discharge from hospital.

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The Power of Pulse Oximetry to Improve Post-Discharge Survival: Matthew Wiens

  1. 1. Matthew Wiens, PharmD, PhD PULSE OXIMETRY TO IMPROVE POST-DISCHARGE SURVIVAL IN UGANDA
  2. 2. Multi-site cohort study: Mbarara, Uganda Admission n=1307 Discharge n=1242 Post-discharge mortality n=61 AUC = 0.82
  3. 3. Adjusted influence of predictive variables Wiens et al. BMJ Open. 2015;5:e009449
  4. 4. The math is complex!
  5. 5. Pulse oximetry may be unavailable!
  6. 6. English et al. JMIR Mhealth Uheallth. 2016;4(1):e16
  7. 7. English et al. JMIR Mhealth Uheallth. 2016;4(1):e16
  8. 8. English et al. JMIR Mhealth Uheallth. 2016;4(1):e16
  9. 9. English et al. JMIR Mhealth Uheallth. 2016;4(1):e16
  10. 10. Home Referral and Discharge Kit • Education for mother • Post-discharge vulnerability • Health behavior • Early recognition • Early health seeking • Incentives • New bed net • ORS • Soap Wiens et al. Submitted
  11. 11. Impact Outcome Cohort 1 (control) N=1242 Cohort 2 (intervention) N=202 OR (95% CI) Post-discharge health seeking 383 (30%) 177 (90%) 17 (11 – 27) Re-admission 72 (6%) 22 (11%) 2.0 (1.1 – 3.3) Death 41 (3.5%) 5 (2.5%) 0.75 (0.29 – 1.92)
  12. 12. Conclusions 1) Post-discharge mortality is a problem 2) High risk children can be identified • Pulse oximetry is important! 3) Interventions can improve health & save lives 4) Validated & evaluation in larger clinical trials needed

Editor's Notes

  • Post-discharge mortality is a huge problem in places like Uganda, where as many children die during the post-discharge period as during the initial hospitalization. The important question then is: How do we prevent these deaths? Well, in areas with limited resources a good first step would be to be able to identify those children at highest risk of post-discharge mortality so that we can target our limited resources towards these high risk children. This is essentially where we started.

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