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.

1. Matthew Wiens, PharmD, PhD
PULSE OXIMETRY TO
IMPROVE POST-DISCHARGE
SURVIVAL IN UGANDA

2. Multi-site cohort study: Mbarara, Uganda
Admission
n=1307
Discharge
n=1242
Post-discharge
mortality n=61
AUC = 0.82

3. Adjusted influence of predictive variables
Wiens et al. BMJ Open. 2015;5:e009449

4. The math is complex!

5. Pulse oximetry may be unavailable!

6. English et al. JMIR Mhealth Uheallth.
2016;4(1):e16

7. English et al. JMIR Mhealth Uheallth.
2016;4(1):e16

8. English et al. JMIR Mhealth Uheallth.
2016;4(1):e16

9. English et al. JMIR Mhealth Uheallth.
2016;4(1):e16

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. 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. 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