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Predictors of Mortality in Children Admitted With Pneumonia to a Tertiary Hospital in Ghana: A Retrospective Cohort
Sandra Kwarteng Owusu1,2, Richard Kwaku Kwarteng Owusu3, Birgit Agyeiwah Baah4
1Directorate of Child Health Komfo Anokye Teaching Hospital Kumasi Ghana.
Insights
Childhood pneumonia is a major cause of death in low and middle-income countries. Hypoxemia and diarrhea were identified as key predictors of mortality in Ghanaian children with pneumonia.
Area of Science:
- Pediatrics
- Infectious Diseases
- Global Health
Background:
- Pneumonia significantly contributes to childhood mortality in low and middle-income countries (LMICs).
- Predictors of mortality in childhood pneumonia within LMICs are diverse and require further investigation.
- This study focuses on identifying mortality predictors in children with pneumonia at a tertiary hospital in Ghana.
Purpose of the Study:
- To determine the key predictors of in-hospital mortality among children diagnosed with pneumonia in Ghana.
- To analyze demographic, clinical, and outcome data to understand factors influencing pneumonia mortality.
- To contribute to strategies aimed at reducing childhood pneumonia deaths in LMICs.
Main Methods:
- A retrospective cohort study design was employed.
- Data on demographics, clinical features, and admission outcomes were reviewed for children admitted with pneumonia.
- In-hospital mortality was the primary outcome measure, with survival and death analyzed.
Main Results:
- The study included 394 children with complete medical records, revealing a 19% mortality rate from pneumonia.
- Hypoxemia at presentation (38.6% vs. 17%) and the presence of diarrhea were significantly associated with increased mortality.
- Diarrhea (aHR=2.19) and hypoxemia (aHR=2.08) were identified as independent predictors of mortality.
Conclusions:
- A high burden of pneumonia was observed, particularly in very young children.
- Hypoxemia and diarrhea emerged as critical predictors of mortality in this pediatric cohort.
- Findings underscore the need for targeted interventions addressing these risk factors to reduce pneumonia-related deaths.
Background And Aim:
Pneumonia contributes substantially to the childhood mortality burden in low and middle-income countries (LMICs). Reported predictors of mortality in childhood pneumonia in LMIC are varied. This study aimed to describe predictors of mortality among children with pneumonia in a tertiary hospital in Ghana.
Methods:
A retrospective cohort study that reviewed demographics, clinical features, admission outcomes, and predictors of in-hospital mortality among Ghanaian children admitted with pneumonia. Outcome measures of interest were survival and death.
Results:
A total of 630 children were eligible for the study; 394 (62.5%) had medical records that were at least 85% complete. 56% (n = 220) were males. Children who died had a median age of 8 months (IQR: 4-17) and 12 months (IQR: 6-24) for the survivors. Among children with pneumonia, 74% (n = 290) were younger than 24 months, and 73.3% (n = 239) were fully immunized. Mortality rate was 19% (n = 75/394), 34 children died within 24 h of admission, and a cumulative 42 children died within 48 h of admission. Hypoxemia at presentation was more frequent, 38.6% (n = 27), among those who died compared to the survivors, 17% (n = 47). Lower chest wall indrawing (LCI) occurred in both groups (80% vs. 60%, respectively). Predictors of mortality included; presence of diarrhea (aHR = 2.19, 95% CI:1.02-4.71, p = 0.05), hypoxemia (aHR = 2.08, 95% CI:1.09-3.96, p = 0.03).
Conclusion:
We observed a high burden of pneumonia in very young children. The predictors of mortality were hypoxemia and diarrhea.
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