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Risk factors for complicated community-acquired pneumonia in children
Gökçen Dilşa Tuğcu1, Beste Özsezen1, İrem Türkyılmaz2
1Department of Pediatric Pulmonology, Children's Hospital, Ankara City Hospital, University of Health Science, Çankaya/Ankara, Turkey.
Insights
Identifying risk factors for complicated community-acquired pneumonia (CAP) in children is crucial. Hypoxia, respiratory distress, and pleural effusion are key indicators of severe pediatric CAP requiring prompt medical attention.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Critical Care Medicine
Background:
- Community-acquired pneumonia (CAP) is a significant cause of childhood illness and death globally.
- Understanding risk factors for complicated CAP (CCAP) can improve early diagnosis and treatment strategies.
Purpose of the Study:
- To identify clinical and laboratory factors associated with the development of complicated CAP in hospitalized children.
- To differentiate between uncomplicated CAP and CCAP in a pediatric cohort.
Main Methods:
- Retrospective cohort study of pediatric patients hospitalized with CAP or CCAP.
- Data collection included patient demographics, clinical presentation, laboratory values, and hospitalization details.
Main Results:
- CCAP patients were older and showed higher C-reactive protein levels and more frequent hypoxia on admission compared to CAP patients.
- Significant differences in mean age (p=0.012) and C-reactive protein levels (p=0.007) were observed.
- Hypoxia upon admission was a highly significant indicator of CCAP (p < 0.001).
Conclusions:
- Hypoxia, respiratory distress, and pleural effusion on imaging are critical indicators distinguishing CCAP in children.
- Establishing specific etiology, diagnostic criteria, and treatment protocols for CCAP is essential.
- Implementing protective measures can help mitigate the impact of severe pediatric pneumonia.
Background:
Community-acquired pneumonia (CAP) in children continues to be one of the prominent causes of pediatric morbidity and mortality worldwide. By determining the risk factors associated with the development of complicated CAP (CCAP), new approaches for early diagnosis and effective treatment can be identified.
Methods:
This retrospective cohort study enrolled patients with CAP and CCAP who visited the pediatric ward of the study hospital between January 1, 2017 and December 31, 2017. For patients with CCAP, data regarding medical procedures performed, surgical intervention, and hospitalization duration were collected.
Results:
A total of 111 patients, 93 (83.7%) with CAP and 18 (16.3%) with CCAP, aged between 3 months and 18 years were hospitalized because of severe pneumonia. The mean age of the patients was 3.6 ± 1.2 years and 60 (54%) of them were female. The mean age of patients with CCAP was higher than that of patients with CAP (4.2 ± 3.3 vs. 2.8 ± 2.1 years respectively); however, the difference was not significant (p = 0.012). Patients with CCAP exhibited a significantly higher C-reactive protein level than those with CAP (10.06 ± 7.55 vs. 4.43 ± 3.37 g/L respectively; p = 0.007). Hypoxia upon admission was noted more commonly in the CCAP group than in the CAP group (p < 0.001).
Conclusion:
Findings related to hypoxia, respiratory distress, and pleural effusion on imaging are important distinguishing factors associated with the development of complications in patients hospitalized with CAP. Therefore, CCAP etiology, diagnosis, and treatment approaches should be established and protective measures adopted.
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