Risk factors for mortality in community-acquired pneumonia among children aged 1–59 months admitted in a referral hospital

Abstract

Among 1 month to 59 months old hospitalized children with pneumonia, CFR was 8.2%. Need for assisted ventilation was a significant risk factor associated with mortality.

Risk factors for mortality in children hospitalized with pneumonia

“…Association of underlying congenital heart disease with pneumonia mortality reported between 7-12% within the groups [5] is comparable to other studies from India though much higher figures have been reported from China [2]. Presence of co-morbidities, in this study particularly diarrhea and HIV, has been reported as an important risk factor for severe pneumonia in areas with high prevalence of HIV [4].…”

“…A study from Delhi [1] has demonstrated this important association of severity of illness with CFR ranging from 0-47% in children with pneumonia, severe pneumonia, and very severe pneumonia as per WHO classification. In the study by Ramachandran, et al [5] 47-68% of the children who died required assisted ventilation which is much higher than reported by others [2]. It is difficult to understand the VOLUME 49 __ NOVEMBER 16, 2012 EDITORIALS practical importance of this association because the clinical course and pathway to death can not be visualized if the cases are not categorized based on severity of illness at the time of admission.…”

“…In this issue, Ramachandran, et al [5] attempt to review the situation based on retrospective chart review of 4375 children over a period of 3 years. The case fatality rate (CFR) has been reported as 8.2% which is comparable to earlier published reports [1].…”

“…These observations support a thorough clinical assessment at the time of admission to pick up underlying co-morbidities in order to provide optimum treatment for these specific conditions. Weight for age <-2 Z score has been significantly associated with mortality [5]. Pneumonia is more common and more likely to be fatal in children with severe malnutrition.…”

Abordagem hierarquizada para a identificação de fatores associados à hospitalização por pneumonia, em menores de cinco anos de idade: estudo caso-controle

“…Além de contribuírem para a hospitalização, os fatores nutricionais e as comorbidades também podem contribuir para a mortalidade por pneumonia, de acordo com um estudo transversal indiano, no qual a análise multivariada revelou associação do escore-z de peso para idade <-2 (OR=1,12) e da doença cardíaca congênita (OR=1,39) com o desfecho (RAMACHANDRAN, et al, 2012). Ding et al (2012) também descreveram o papel das doenças de base na severidade da pneumonia entre crianças chinesas, sendo responsáveis por um expressivo incremento na chance de desenvolver um quadro grave (OR=6,62).…”