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Pneumonia Prevention Strategies for Children With Neurologic Impairment

Jody L Lin1, Keith Van Haren2, Joseph Rigdon3

  • 1Division of Pediatric Hospital Medicine, Department of Pediatrics, jodyl@stanford.edu.

Pediatrics
|September 21, 2019
PubMed

Insights

Dental care may reduce recurrent severe pneumonia in children with neurologic impairment (NI). Other strategies like gastrostomy tubes increased risk, warranting further research into effective prevention for this vulnerable population.

Area of Science:

  • Pediatric Pulmonology
  • Neurology
  • Infectious Diseases

Background:

  • Children with neurologic impairment (NI) have a high risk of recurrent severe pneumonia.
  • The effectiveness of current prevention strategies for severe pneumonia in this population is not well understood.

Purpose of the Study:

  • To evaluate the comparative effectiveness of secondary prevention strategies for severe pneumonia in children with NI.

Main Methods:

  • A cohort of 3632 children with NI and prior pneumonia hospitalization was analyzed.
  • Propensity score matching (1:2) was used to adjust for covariates.
  • Associations between subsequent pneumonia hospitalizations and various prevention strategies were examined.

Main Results:

  • Dental care was linked to a reduced risk of subsequent pneumonia (aOR: 0.64; 95% CI: 0.49-0.85).
  • Gastrostomy tube placement (aOR: 2.15), chest physiotherapy (aOR: 2.03), and clinic visits (aOR: 1.30-1.72) were associated with increased pneumonia risk.

Conclusions:

  • Dental care shows promise in decreasing severe pneumonia recurrence in children with NI.
  • Further clinical trials are recommended to confirm the benefits of dental care for pneumonia prevention in this group.
Abstract

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