Community-Acquired Pneumonia in Young Children: Variables Associated With Emergency Department Attendance and...

This study was aimed at identifying variables associated with attending pediatric emergency departments (PEDs) and hospitalization of young children with community-acquired pneumonia (CAP).

A population-based case-control study, which included all children aged 1-6 years diagnosed with CAP from three major districts of a health maintenance organization during 2014-2020. Children born preterm, or with chronic lung diseases or immunodeficiency, were excluded. The cohort was divided into three groups: children diagnosed and treated by the community pediatrician, those who attended PEDs, and those hospitalized.

The cohort comprised 59,662 children with CAP, of whom 3685 (6.2%) attended PEDs and 2026 (3.4%) were hospitalized. Of the children treated in the PED, 33% were hospitalized versus 1.4% of those diagnosed in the community. Using multivariable analyses, members of a minority sector, low or middle socioeconomic status, elevated white blood cell count, and high C-reactive protein levels were independently and significantly associated with PED attendance and hospitalization.

Community pediatricians should integrate the identified variables associated with attending PEDs and hospitalization to optimize management of children with CAP, given the potential for complications and mortality. The recognized 6.2% PED attendance and 3.4% hospitalization, with the identified related associations, have implications for pediatric healthcare planning.