Mortality predictors of pneumonia in children

Abstract

Background Pneumonia is one of the main causes of death in children in developing countries. It is important to identify clinical signs, demographic factors, and laboratory data which can be used to predict children who have higher risk of mortality from pneumonia.Objective To find the clinical signs, demographic factors and laboratory data that can be used as predictors of mortality from pneumonia.Methods T his historical case􀀽control study was carried out in Sardjito Hospital between January 2004 and December 2006. Data were obtained from medical records. Differential proportion between groups was analyzed with chi square. Regression analysis was used to identify clinical factors, demographic factors and laboratory factors that associated with mortality from pneumonia.Results Fifty􀀽eight patients were enrolled in this study, 29 patients were dead (case group) and 29 patients were cured (control group). Baseline data between the two groups were similar in terms of gender and mean of age. Bivariate analyses show that the predictors of mortality in children with pneumonia were: age < 1 year (OR3.11, 95% CI 1.06 to 9.08), malnutrition (OR 7.30,95% CI 1.62- to 21.03), age of the mother < 20 years (OR 2.21,95%CI 1.64 to 2.97),t achycardia (OR 6.075,95% CI 1.18 to 31.24), and anemia (OR 5 .83, 95% CI 1.88 to 18.10). Logistic regression analysis shows that tachycardia (OR 6.04, 95% CI 1.01 to 36.17) and anemia (OR 4.41,95% CI 1.25 to 15.51) were predictor of mortality in children 'With pneumonia.Conclusions Tachycardia and anemia play as independent mortality predictors of pneumonia in children.

Hubungan Faktor Risiko dan Karakteristik Gejala Klinis dengan Kejadian Pneumonia pada Balita

“…Hal ini dijelaskan bahwa anak di bawah usia 1 tahun memiliki saluran napas yang lebih sempit sehingga akan mudah menderita infeksi saluran pernapasan seperti pneumonia dan bila area yang terkena peradangan bertambah luas akan menyebabkakan risiko terjadinya obstruksi saluran pernapasan dan meningkatkan kejadian hipoksia. 11 Penelitian di negara Zambia dinyatakan bahwa pneumonia merupakan penyebab utama kesakitan pada anak di bawah usia 5 tahun, 12 hal ini dapat terjadi karena pada usia tersebut anak balita sudah mulai mengetahui lingkungan untuk bermain di luar rumah sehingga akan mudah terpapar oleh agen penyebab pneumonia dan didukung oleh respons imunitas yang belum berkembang dengan baik. 5 Jenis kelamin anak balita yang datang untuk berobat ke UPT Puskesmas Ibrahim Aji didominasi oleh balita laki-laki sebanyak 59% bila dibandingkan dengan perempuan sebanyak 41%.…”

Bacterial pneumonia score to identify bacterial pneumonia

“…10 The most common nutritional status of our subjects was undernourished (53.49%). In contrast, Kisworini et al 8 and Beyeng et al 9 found more pneumonia patients in the well-nourished category with 69% and 51.1%, respectively. Sensitivity, specificity, positive predictive value and negative predictive value were different from those reported by Moreno et al, 5 who examined the development and validation of clinical predictors for distinguishing bacterial and viral pneumonia in children.…”

“…This result was different from that obtained by Kisworini et al, who examined clinical symptoms, laboratory and demographic data as predictors of mortality in children with pneumonia and Beyeng et al, who examined BPS validity as a predictor of pneumonia bacteremia in children. Kisworini et al 8 and Beyeng et al 9 found the average ages of their sample who suffered from pneumonia, to be 16 month and 11 months, respectively. However, Torres et al, who examined the clinical predictors for initial treatment our hospital criteria: fever, cough, shortness of breath (based on age according to WHO), 7 respiratory distress (or nasal flaring and grunting and/or suprasternal/ intercostal/subcostal retractions), and smooth wet loud rales on chest auscultation.…”

Procalcitonin for detecting community-acquired bacterial pneumonia

“…This result was similar to studies by Kisworini P et al and Beyeng et al which had mean subject ages of 16 and 11 months, respectively. 13,14 The peak 70%, respectively). Another study also reported that procalcitonin (cut-off point 0.25 ng/mL) had higher diagnostic accuracy than that of CRP and that total leukocytes can differ between community-acquired pneumonia and infection cause.…”

“…Similarly, Kisworini et al and Beyeng et al had more boys than girls in their studies, with 55% and 59.4%, respectively. 13,14 Our largest subject age group was under five years (99%), with children aged 2-11 months comprising 46%, and those aged 1-4 years comprising 53%. This result was similar to studies by Kisworini P et al and Beyeng et al which had mean subject ages of 16 and 11 months, respectively.…”