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Factors determining the outcome of children hospitalized with severe pneumonia

Karalanglin Tiewsoh1, Rakesh Lodha, Ravindra M Pandey

  • 1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India. karalanglin@rediffmail.com

BMC Pediatrics
|February 25, 2009
PubMed

Insights

Severe pneumonia in children under five is a major health concern. Lack of exclusive breastfeeding, overcrowding, and abnormal chest X-rays are linked to antibiotic treatment failure and prolonged hospital stays in severe pneumonia cases.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Pneumonia is a leading cause of death in children under five globally.
  • Severe pneumonia presents a significant morbidity and mortality challenge in hospitalized young children.

Purpose of the Study:

  • To identify factors associated with mortality and morbidity in children under five hospitalized with severe pneumonia.
  • To analyze determinants for antibiotic treatment failure, prolonged hospitalization, mechanical ventilation, and mortality.

Main Methods:

  • A study involving 200 hospitalized children aged 2-60 months with World Health Organization (WHO) defined severe pneumonia.
  • Standardized management protocol with close follow-up for antibiotic changes, hospital stay duration, mechanical ventilation, and mortality.
  • Multivariate analysis to identify influencing factors for various outcomes.

Main Results:

  • Over half of the children required antibiotic changes (56.5%), and 51% had prolonged hospital stays (>5 days). Mortality was 10.5%, with 20.5% needing mechanical ventilation.
  • Lack of exclusive breastfeeding, overcrowding, and abnormal chest X-rays were associated with antibiotic changes and prolonged hospital stays.
  • Factors like head nodding, altered sensorium, abnormal leukocyte counts, and pallor were linked to mortality. Cyanosis and head nodding predicted the need for mechanical ventilation.

Conclusions:

  • Children with severe pneumonia not exclusively breastfed, living in overcrowded conditions, or with abnormal chest X-rays were more likely to experience treatment failure and prolonged hospital stays.
  • In radiographically confirmed pneumonia, lack of breastfeeding and low birth weight were associated with the need for antibiotic changes.
  • Identifying these risk factors is crucial for improving management and outcomes for severe pneumonia in young children.
Abstract

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