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Published on: February 23, 2014
Community-Acquired Pneumonia Hospitalization among Children with Neurologic Disorders
Alexander J Millman1, Lyn Finelli2, Anna M Bramley2
1Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA.
Insights
Children with neurologic disorders hospitalized for community-acquired pneumonia (CAP) were more likely to need intensive care. Pathogen detection was less frequent in these children compared to those without neurologic conditions.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- Community-acquired pneumonia (CAP) presents unique challenges in children with underlying health conditions.
- Neurologic disorders can significantly impact the clinical course and outcomes of pediatric CAP.
- Understanding these differences is crucial for optimizing patient care and resource allocation.
Purpose of the Study:
- To compare the clinical characteristics, outcomes, and causes of CAP in children with and without neurologic disorders.
- To identify specific risk factors and clinical trajectories associated with CAP in children with neurologic conditions.
Main Methods:
- Retrospective analysis of 2358 children hospitalized with radiographically confirmed CAP across three US children's hospitals (January 2010-June 2012).
- Categorization of patients into three groups: those with neurologic disorders, those with non-neurologic underlying conditions only, and those with no underlying conditions.
- Utilized bivariate, age-stratified, and multivariate logistic regression to compare epidemiology, etiology, and clinical outcomes.
Main Results:
- Children with neurologic disorders were older and had higher rates of intensive care unit (ICU) admission compared to other groups.
- Mechanical ventilation rates were similar across groups, but pathogen detection was less frequent in children with neurologic disorders.
- Multivariate analysis indicated that neurologic disorders were associated with ICU admission in children aged 2 years and older.
Conclusions:
- Pediatric patients with neurologic disorders hospitalized for CAP exhibit distinct clinical patterns, including increased ICU admission rates.
- The lower detection rate of pathogens in children with neurologic disorders warrants further investigation into diagnostic and treatment strategies.
- Neurologic disorders are a significant factor influencing CAP severity and outcomes in hospitalized children.
Objective:
To describe and compare the clinical characteristics, outcomes, and etiology of pneumonia among children hospitalized with community-acquired pneumonia (CAP) with neurologic disorders, non-neurologic underlying conditions, and no underlying conditions.
Study Design:
Children <18 years old hospitalized with clinical and radiographic CAP were enrolled at 3 US children's hospitals. Neurologic disorders included cerebral palsy, developmental delay, Down syndrome, epilepsy, non-Down syndrome chromosomal abnormalities, and spinal cord abnormalities. We compared the epidemiology, etiology, and clinical outcomes of CAP in children with neurologic disorders with those with non-neurologic underlying conditions, and those with no underlying conditions using bivariate, age-stratified, and multivariate logistic regression analyses.
Results:
From January 2010-June 2012, 2358 children with radiographically confirmed CAP were enrolled; 280 (11.9%) had a neurologic disorder (52.1% of these individuals also had non-neurologic underlying conditions), 934 (39.6%) had non-neurologic underlying conditions only, and 1144 (48.5%) had no underlying conditions. Children with neurologic disorders were older and more likely to require intensive care unit (ICU) admission than children with non-neurologic underlying conditions and children with no underlying conditions; similar proportions were mechanically ventilated. In age-stratified analysis, children with neurologic disorders were less likely to have a pathogen detected than children with non-neurologic underlying conditions. In multivariate analysis, having a neurologic disorder was associated with ICU admission for children ≥2 years of age.
Conclusions:
Children with neurologic disorders hospitalized with CAP were less likely to have a pathogen detected and more likely to be admitted to the ICU than children without neurologic disorders.
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