Factors associated with mortality in pediatric pneumonia patients supported with mechanical ventilation in developing country

Abstract

Background: Pneumonia is still a major cause of death and incurs significant morbidity and mortality in developing countries. Thus, patients care does not only focus on treatment but also identifying factors that associated with the patient's outcome. Therefore we defined factors associated with mortality in pediatric pneumonia and assessed the outcome of pneumonia supported by mechanical ventilation in children. Methods: We performed cohort retrospective study by collecting data of pediatric pneumonia patients who admitted to Pediatric Intensive Care Unit (PICU) at Dr. Sardjito General Hospital, from 2014 to 2016. Chi square and multivariate logistic regression tests were used to analyze the variables: anemia, comorbidities, bacteremia, age between 1-6 months old, and underweight as associated factors for mortality. Results: One hundred and eleven children were included in this study. Those patients were diagnosed as community acquired pneumonia (79.3%), hospital acquired pneumonia (14.4%) and ventilator associated pneumonia (6.3%), with mortality rate 47.7%. Multivariate logistic regression analysis revealed that bacteremia, and underweight could be used as predictor factors of mortality for pediatric patients with pneumonia who were supported by mechanical ventilation with OR 2.5 (CI 95%: 1.03-6.1) and 2.4 (CI 95%: 1.1-5.7), respectively. Conclusion: Factors associated with mortality for pediatric patients with pneumonia who were supported by mechanical ventilation were bacteremia and underweight. It is necessary to compare our findings with other centers.

Prevalence of persistent pneumonia among severe pneumonia and nutritional status as its associated risk factor: A prospective observational study among under-five children

“…Similar age prevalence was seen in other studies where children under 5 years of age with persistent pneumonia were mostly under 24 months of age. [ 22 23 ] Children under 1 year of age have relatively narrower respiratory tracts due to which they easily succumb to longer duration of morbidity due to pneumonia. [ 23 ] There was male preponderance in all three studied types of pneumonia, which was 81.2% in recurrent, 42.9% in persistent and 76.6% in severe pneumonia children, although this distribution was not statistically significant.…”

“…[ 22 23 ] Children under 1 year of age have relatively narrower respiratory tracts due to which they easily succumb to longer duration of morbidity due to pneumonia. [ 23 ] There was male preponderance in all three studied types of pneumonia, which was 81.2% in recurrent, 42.9% in persistent and 76.6% in severe pneumonia children, although this distribution was not statistically significant. Male dominance was observed in other studies where community-acquired pneumonia was studied.…”

“…Male dominance was observed in other studies where community-acquired pneumonia was studied. [ 22 23 24 25 ] This can be attributed to the fact that male child has better health-seeking behaviour as compared to female child in India. [ 26 ]…”

“…Similar significant distribution of malnourishment in children with pneumonia was observed by other researchers also. [ 21 22 23 24 25 ] A study by Artawan et al . [ 20 ] also revealed that there was a statistically significant relationship between the severity of pneumonia and status of nutrition ( P = 0.02), with 2.176 higher risk of suffering from severe pneumonia among the malnourished children.…”

Waspadai dan Cegah Pneumonia dan Diare di Masa Pandemi Covid-19

“…Anak kecil sering mengalami Infeksi Saluran Pernapasan Akut (ISPA) yang sebagian besar merupakan infeksi saluran pernapasan pada bagian atas (Simoes et al, 2006). Pneumonia merupakan penyebab utama morbiditas dan mortalitas pada anak di bawah usia 5 tahun (Meliyanti et al, 2021). Pneumonia merupakan penyakit infeksi menular dan penyebab kematian terbesar pada balita di dunia.…”