Outcome predictors of severe and very severe pneumonia in children between 2 and 59 months of age admitted in a tertiary care hospital
Journal Title: Indian Journal of Child Health - Year 2017, Vol 4, Issue 1
Abstract
Objective: The objective of this study was to determine the factors associated with outcome (morbidity and mortality) in children aged 2-59 months with severe and very severe pneumonia. Materials and Methods: This is a hospital-based, prospective, observational study conducted in the pediatric department of a tertiary care hospital. Totally 300 children of either sex between 2 and 59 months of age with the WHO-defined severe pneumonia and very severe pneumonia were enrolled in the study. Associations of outcomes and various clinical symptoms were assessed using Chi-square test first and then through logistic regression models. Results: In our study, 86 (28.7%) children stayed in hospital more than 5 days, 113 (37.7%) needed change in antibiotics, 24 (8%) developed complications (5% effusion and 3% pneumothorax), and 31 (10.3%) expired. Multivariate analysis showed that younger age at presentation, household pollution (cooking fuel other than liquefied petroleum gas), and children who did not receive exclusive breastfeeding were prone to develop more severe pneumonia. Head nodding and cyanosis were independent factors significantly associated with mortality on multiple logistic regression. Radiologically proven pneumonia cases required change in antibiotics more frequently and stayed for longer duration in hospital as compared to clinical pneumonia cases. Conclusions: Children with signs of severe respiratory distress such as head nodding, cyanosis and altered sensorium, anemia, decreased or increased total leukocyte count, and hypoxemia have greater risk of mortality. Children with risk factors including overcrowding, indoor air pollution, lack of exclusive breastfeeding and proper immunization, and abnormal chest radiograph are less likely to respond to the first-line antibiotics; therefore, they may be treated aggressively with the second-line antibiotics from the beginning so that their hospital stay may be reduced.
Authors and Affiliations
Ehtesham Ansari, Ajay Kumar, K C Aggarwal, K R Meena, Murtaza Kamal
Keywords
Related Articles
- EP ID EP454082
- DOI -
- Views 108
- Downloads 0
Medical research and ethics - Revisited
Ethics in the medical research is known since many years; however, there have been new developments in this area recently. A phenomenal improvement in the health-care system, leading to increased life expectancy, and the...
Association of cord blood and maternal lipid profiles
Objectives: The objectives of this study were to study the cord blood lipid profile in neonates in relation to maternal preconceptional body mass index (BMI), maternal glucose intolerance, maternal lipid profile, family...
Infatuation and love of an adolescent girl: Dynamics of parent child relationship
Background: Increased interest in romantic relationship (RR) is central to adolescents’ lives. RR has a significant influence on the emotional well-being of the adolescents and their future life. Objective: The present s...
Utility of serial serum C-reactive protein in the diagnosis of neonatal infection
Introduction: C-reactive protein (CRP) has been used as a biomarker to diagnose neonatal sepsis. Aim: The aim of the study was to study the utility of serial CRP levels in the neonatal infection/sepsis diagnosis. Materia...
Dengue hepatic severity score: A glimmer to the clinician
Introduction: Recent studies from India and Thailand show that dengue infection was the most compelling cause of acute hepatic failure in children contributing to 18.5% and 34.3%, respectively, and till now, there is no...