Risk factors for community‐acquired pneumonia in pre‐school‐aged children

Grant, Cameron C.; Emery, Diane P; Milne, Tania; Coster, Gregor; Forrest, Christopher B.; Wall, Clare; Scragg, Robert; Aickin, Richard; Crengle, Sue; Leversha, Alison; Tukuitonga, Colin; Robinson, Elizabeth

doi:10.1111/j.1440-1754.2011.02244.x

Cited by 57 publications

(76 citation statements)

References 46 publications

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“…Surprisingly, we did not observe any significant relationship between housing conditions and severity of CAP among the studied subjects ( P > 0.05 ), which was contrary to our expectations and to previous findings of Grant et al, who reported that lower quality living environments increase the risk of CAP and that improving housing quality may reduce the burden of CAP in New Zealand [23]. However, reporting in our study may have been unreliable, and a study to cover an extended population is recommended to better assess housing quality in the Nile Delta of Egypt, both in rural and urban areas.…”

Section: Discussioncontrasting

confidence: 99%

Impact of the socioeconomic status on the severity and outcome of community-acquired pneumonia among Egyptian children: a cohort study

et al. 2014

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BackgroundCommunity-acquired pneumonia (CAP) is one of the five leading causes of death among children in developing countries, accounting for approximately three million deaths per year. Identification of the modifiable risk factors of CAP may help to reduce the burden of this disease. In this study, the impact of the socioeconomic status (SES) on the severity and outcome of CAP among Egyptian children was studied.MethodsThis was a prospective longitudinal cohort study which included 1,470 children diagnosed with CAP, aged two to 15 years (median age 5.4 years). The diagnosis of CAP was based on clinical and radiological findings. A structured questionnaire and the patients’ medical records were used for the data collection. The subjects were divided into two groups: mild and severe CAP. Social and demographic variables were compared, and a multivariate logistic regression analysis was performed.ResultsThe multivariate analysis showed that a low maternal education level (OR: 3.8; 95% CI: 2.12 –6.70; P = .0001), unavailability of adequate medical care (OR: 3.1; 95% CI: 1.99 –4.88; P = .0001), a low family income (OR: 2.2; 95% CI: 0.99 –4.78; P = .047), and parents’ smoking habits (OR: 2.0; 95% CI: 1.15 –3.55; P = .014) were significant independent predictive risk factors for severe CAP among Egyptian children.ConclusionPublic health measures against these socio-demographic risk factors should be identified as priorities in order to help reduce the disease burden of deaths from severe CAP among Egyptian children.

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Section: Discussioncontrasting

confidence: 99%

Impact of the socioeconomic status on the severity and outcome of community-acquired pneumonia among Egyptian children: a cohort study

et al. 2014

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“…Respiratory failure, sepsis and cardiac complication are considered the most important direct causes of death among patients with pneumonia [3,4]. Risk factors for acquiring pneumonia were clearly detected by previous studies [5,6]. However, there are lack of studies that investigate risk factors and predictors for poor pneumonia outcome in children.…”

Section: Introductionmentioning

confidence: 97%

Usefulness of gender and abnormal blood count for predicting pneumonia outcome in children

Atwa

2015

Egyptian Journal of Chest Diseases and Tuberculosis

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Background: Pneumonia is still a leading cause of death among children in developing countries.The aim of the study is to identify some risk factors for poor pneumonia outcome. The studied factors were: male sex, thrombocytosis, thrombocytopaenia, leucocytosis, leucopaenia and anaemia.Patients and methods: A prospective cross sectional study included 242 children with community acquired pneumonia (CAP) who were attending a tertiary care hospital. Work for the study started at October 2012 and ended at August 2014. Medical history, physical examination, complete blood count (CBC) and C-reactive protein were done for all patients.Results: 27.3% of the patients developed pulmonary complications, 17.4% acquired sepsis while death occurred in 3.7% of cases. Multinomial logistic regression was used to detect the independent effect of each studied factor. Thrombocytosis, anaemia and age 62 years were associated with the development of pulmonary complications. Thrombocytopaenia and leucopaenia were associated with the fatal course of the disease. Male sex was a protective factor against pulmonary complications; however it was a risk factor for acquiring sepsis. Leucocytosis did not affect the prognosis of CAP.Conclusion: Sex of the patient and data from complete blood count are very useful for the prediction of pneumonia outcome. Anaemia, thrombocytosis, thrombocytopaenia, and leucopaenia are considered as predictors of bad prognosis. Females are more vulnerable to pulmonary complications while maleness is associated with sepsis and determination of these indicators highlights suspicion of pneumonia prognosis and allows application of early appropriate interventions.

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“…This difference may be due to our approach of obtaining blood cultures on all patients rather than selectively in patients perceived to be more severely ill. 3,4,6,[27][28][29][30] This may be a closer estimate of the true rate of bacteremia in admitted patients with CAP.…”

Section: Discussionmentioning

confidence: 99%

Improvement Methodology Increases Guideline Recommended Blood Cultures in Children With Pneumonia

et al. 2015

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BACKGROUND AND OBJECTIVE: A national evidence-based guideline for the management of community-acquired pneumonia (CAP) in children recommends blood cultures for patients admitted with moderate to severe illness. Our primary aim was to increase ordering of blood cultures for children hospitalized with CAP from 53% to 90% in 6 months. The secondary aim was to evaluate the effect of obtaining blood cultures on length of stay (LOS). METHODS:At a tertiary children's hospital, interventions to increase blood cultures focused on 3 key drivers and were tested separately in the emergency department and inpatient units by using multiple plan-do-study-act cycles. The impact of the interventions was tracked over time on run charts. The association of ordering blood cultures and LOS was estimated by using linear regression models.RESULTS: Within 6 months, the percentage of patients admitted with CAP who had blood cultures ordered increased from 53% to 100%. This change has been sustained for 12 months. Overall, 239 (79%) of the 303 included patients had a blood culture ordered; of these, 6 (2.5%) were positive. Patients who had a blood culture did not have an increased LOS compared with those without a blood culture.CONCLUSIONS: Quality improvement methods were used to increase adherence to evidence-based national guidelines for performing blood cultures on children hospitalized with CAP; LOS did not increase. These results support obtaining blood cultures on all patients admitted with CAP without negative effects on LOS in a setting with a reliably low false-positive blood culture rate. Dr Murtagh Kurowski participated in the design of the study, developed the data collection criteria, carried out the statistical analysis, performed chart reviews, designed and executed interventions, and drafted the initial manuscript; Dr Shah participated in the design of the study, participated in the design of the interventions, developed the data collection criteria, and reviewed all drafts of the manuscript; Drs Thomson and Statile participated in the design of the study, performed chart reviews, designed and executed interventions, and reviewed all drafts of the manuscript; Ms Sheehan participated in the design of the study, performed chart reviews, carried out statistical analysis, and reviewed all drafts of the manuscript; Dr Iyer participated in the design of the study, participated in the design of the interventions, supervised the statistical analysis, and reviewed all drafts of the manuscript; Dr White participated in the design of the study, participated in the design of the interventions, developed the data collection criteria, and reviewed all drafts of the manuscript; Dr Ambroggio participated in the design of the study, developed the data collection criteria, performed chart reviews, carried out the statistical analysis, executed interventions, and reviewed all drafts of the manuscript; and all authors approved the final manuscript for submission.www.pediatrics.org/cgi

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Risk factors for community‐acquired pneumonia in pre‐school‐aged children

Cited by 57 publications

References 46 publications

Impact of the socioeconomic status on the severity and outcome of community-acquired pneumonia among Egyptian children: a cohort study

Impact of the socioeconomic status on the severity and outcome of community-acquired pneumonia among Egyptian children: a cohort study

Usefulness of gender and abnormal blood count for predicting pneumonia outcome in children

Improvement Methodology Increases Guideline Recommended Blood Cultures in Children With Pneumonia

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