• Brooklyn R Nemetchek, LiangLi DannyLDFaculty of Medicine, University of Toronto, Toronto, Canada., Niranjan Kissoon, J Mark Ansermino, Jerome Kabakyenga, Pascal M Lavoie, Susan Fowler-Kerry, and Matthew O Wiens.
• College of Nursing, University of Saskatchewan, Saskatoon, Canada.
• Afr Health Sci. 2018 Dec 1; 18 (4): 1214-1225.

BackgroundOver two-thirds of the five million annual deaths in children under five occur in infants, mostly in developing countries and many after hospital discharge. However, there is a lack of understanding of which children are at higher risk based on early clinical predictors. Early identification of vulnerable infants at high-risk for death post-discharge is important in order to craft interventional programs.ObjectivesTo determine potential predictor variables for post-discharge mortality in infants less than one year of age who are likely to die after discharge from health facilities in the developing world.MethodsA two-round modified Delphi process was conducted, wherein a panel of experts evaluated variables selected from a systematic literature review. Variables were evaluated based on (1) predictive value, (2) measurement reliability, (3) availability, and (4) applicability in low-resource settings.ResultsIn the first round, 18 experts evaluated 37 candidate variables and suggested 26 additional variables. Twenty-seven variables derived from those suggested in the first round were evaluated by 17 experts during the second round. A final total of 55 candidate variables were retained.ConclusionA systematic approach yielded 55 candidate predictor variables to use in devising predictive models for post-discharge mortality in infants in a low-resource setting.

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