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Published on: June 28, 2018
Factors associated with mortality in pediatric pneumonia patients supported with mechanical ventilation in developing
Ari Meliyanti1, Desy Rusmawatiningtyas1, Firdian Makrufardi1
1Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia.
Insights
Bacteremia and underweight are key factors predicting mortality in pediatric pneumonia patients requiring mechanical ventilation. Early identification and intervention for these conditions are crucial for improving outcomes in critically ill children.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Respiratory medicine
Background:
- Pneumonia remains a significant cause of mortality and morbidity in developing nations.
- Effective patient care necessitates identifying factors associated with adverse outcomes.
- Understanding these factors is crucial for improving the management of pediatric pneumonia.
Purpose of the Study:
- To define factors associated with mortality in pediatric pneumonia.
- To assess the outcomes of pediatric pneumonia patients supported by mechanical ventilation.
Main Methods:
- A retrospective cohort study was conducted on pediatric pneumonia patients admitted to the Pediatric Intensive Care Unit (PICU) from 2014 to 2016.
- Data were analyzed using Chi-square and multivariate logistic regression.
- Key variables analyzed included anemia, comorbidities, bacteremia, age (1-6 months), and underweight status.
Main Results:
- The study included 111 children with pneumonia (community-acquired, hospital-acquired, and ventilator-associated).
- The overall mortality rate was 47.7%.
- Multivariate analysis identified bacteremia (OR 2.5) and underweight (OR 2.4) as significant predictors of mortality in mechanically ventilated pediatric pneumonia patients.
Conclusions:
- Bacteremia and underweight are significant factors associated with mortality in pediatric pneumonia patients on mechanical ventilation.
- These findings highlight the need for targeted interventions for these risk factors.
- Further comparative studies across different centers are recommended.
Background:
Pneumonia is still a major cause of death and incurs significant morbidity and mortality in developing countries. Thus, patients care does not only focus on treatment but also identifying factors that associated with the patient's outcome. Therefore we defined factors associated with mortality in pediatric pneumonia and assessed the outcome of pneumonia supported by mechanical ventilation in children.
Methods:
We performed cohort retrospective study by collecting data of pediatric pneumonia patients who admitted to Pediatric Intensive Care Unit (PICU) at Dr. Sardjito General Hospital, from 2014 to 2016. Chi square and multivariate logistic regression tests were used to analyze the variables: anemia, comorbidities, bacteremia, age between 1-6 months old, and underweight as associated factors for mortality.
Results:
One hundred and eleven children were included in this study. Those patients were diagnosed as community acquired pneumonia (79.3%), hospital acquired pneumonia (14.4%) and ventilator associated pneumonia (6.3%), with mortality rate 47.7%. Multivariate logistic regression analysis revealed that bacteremia, and underweight could be used as predictor factors of mortality for pediatric patients with pneumonia who were supported by mechanical ventilation with OR 2.5 (CI 95%: 1.03-6.1) and 2.4 (CI 95%: 1.1-5.7), respectively.
Conclusion:
Factors associated with mortality for pediatric patients with pneumonia who were supported by mechanical ventilation were bacteremia and underweight. It is necessary to compare our findings with other centers.
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