Mortality predictors of pneumonia in children

Priyanti Kisworini; Amalia Setyati; Sutaryo Sutaryo

doi:10.14238/pi50.3.2010.149-53

Priyanti Kisworini Depattment of Child Health, Gadjah Mada University Medical School/Dr. Sardjito Hospital, Yogyakarta, Central Java
Amalia Setyati Depattment of Child Health, Gadjah Mada University Medical School/Dr. Sardjito Hospital, Yogyakarta, Central Java
Sutaryo Sutaryo Depattment of Child Health, Gadjah Mada University Medical School/Dr. Sardjito Hospital, Yogyakarta, Central Java

DOI: https://doi.org/10.14238/pi50.3.2010.149-53

Keywords: pneumonia, child, mortality predictor

Abstract

Background Pneumonia is one of the main causes of death inÂ children in developing countries. It is important to identifyÂ clinical signs, demographic factors, and laboratory data whichÂ can be used to predict children who have higher risk of mortalityÂ from pneumonia.

Objective To find the clinical signs, demographic factors andÂ laboratory data that can be used as predictors of mortality fromÂ pneumonia.

Methods T his historical caseô€€½control study was carried out inÂ Sardjito Hospital between January 2004 and December 2006.Â Data were obtained from medical records. Differential proportionÂ between groups was analyzed with chi square. RegressionÂ analysis was used to identify clinical factors, demographic factorsÂ and laboratory factors that associated with mortality fromÂ pneumonia.

Results Fiftyô€€½eight patients were enrolled in this study, 29 patientsÂ were dead (case group) and 29 patients were cured (controlÂ group). Baseline data between the two groups were similar inÂ terms of gender and mean of age. Bivariate analyses show that theÂ predictors of mortality in children with pneumonia were: age < 1Â year (OR3.11, 95% CI 1.06 to 9.08), malnutrition (OR 7.30,95%Â CI 1.62- to 21.03), age of the mother < 20 years (OR 2.21,95%
CI 1.64 to 2.97),t achycardia (OR 6.075,95% CI 1.18 to 31.24),Â and anemia (OR 5 .83, 95% CI 1.88 to 18.10). Logistic regressionÂ analysis shows that tachycardia (OR 6.04, 95% CI 1.01 to 36.17)Â and anemia (OR 4.41,95% CI 1.25 to 15.51) were predictor ofÂ mortality in children 'With pneumonia.

Conclusions Tachycardia and anemia play as independentÂ mortality predictors of pneumonia in children.

References

1. WHO, Geneva. Technical bases for the WHO recommendations on the management of pneumonia in children at firsdevel health faciliteis In : Programme for control of acute respiratory infection, 1990.
2. Dowell SF. Kupronis BA. Zell ER, Shay DK. Mortality from pneumonia in children in the United States, 1939 through 1996. N Eng J Med. 2000;342,1399-407.
3. Gunajaya E, Widia 1M. Clinical predictors of hypoxemia in pneumonia. Pediatr Indones. 2003;43:192-7.
4. Lodha R, Bhadauria PS, Kuttikat A V, Puranik M, Gupta S, Pandey RM, et aL Can clinical symptoms or sign accurately predict hypoxemia in children 'With acute lower respiratory tract infections? Indian Pediatrics. 2004;41:129-35.
5. Stekelenburg J, Kashumba E, Wolffers. Factors contributing to high mortality due to pneumonia among under-fives in Kalabo District, Zambia. Trop Med Int Health. 2002;7:886-93.
6. Said M. Pneumonia penyebab utama mortalitas anak balita di Indonesia. Bul IDA!. 2006;45:13-4.
7. Kartasasmita CB, Mintardaningsih, Rosmayudi 0, Suardi AU, Sukandar H. Community trials on case management of acute respiratory infections (ARI) in rural villages. Paediatr Indones. 2001;41:260.3.
8. West TE. Goetghebuer T. Milligan P, Mulholland EK. Weber MW Longô€¨tenn morbidity and mortality following hypoxaemic lower respiratory tract Infection in Gambian children. Bull World Health Organ. 1999;77,144Â·8
9. Nathoo KJ. Nkrumah FK. Ndlovu D. Nhembe M. Pirie DJ, Kowo H. Acute lower respiratory tract infection in hospitalized children in Zimbabwe. Ann Trop Paediatr. 1993; 13,253-61.
10. Sehgal V, Sethi GR, Sachdev HP, Satyanarayana L. Predictors of mortality in subjects hospitalized with acute lower respiratory tract infections. Indian Pediatr. 1997 ;34:213-9.
11 Vejar L, Casteran JC, Navarette P, Sanchesz S, LeCerf P, Castillo C. Risk factors for home deaths due to pneumonia among low socioeconomic level Chilean children, Santiago de Chile. Rev Med Chi!. 2000;128,627-32.
12. Suwanjutha S, Ruangkancha-nasetr S, Chantarojanasiri T,
Hotrakitya S. Risk factors associated with morbidity and mortality of pneumonia in Thai children under 5 years. Southeast Asian J Trop Med Public Health. 1994;25:60Â·6.
13. lvijanthi MQ, Vitri S, Landia S, Makmuri MS. Risk factors of mortality in children under 6-year-old with pneumonia. Presented at 13th Child Health National Congress, Bandung, 2005.
14. Sastroasmoro S, Ismael S. Dasar-dasar metodologi penelitian klinis. 2nd ed. Jakarta:' CV Sagung Seto, 2000.
15. Gunajaya E, Widia 1M. Clinical predictors of hypoxemia in pneumonia. Pediatr Indones. 2003;43:192-7.
16. Usen S. Weber M. Mulholland EK. Jaffar S. Oparaugo A, Omosigho C, et al. Clinical predictors of hypoxaemi in Gambian children with acute lower respiratory tract infection: prospective cohort study. BMJ. 1999;518:86-91.
17. Weber MW, Usen S. Palmer A, Jaffar S. Mulholland EK. Predictors of hypoxaemia in hospital admissions with acute lower respiratory tract infection in a developing country. Arch Dis Child. 1997;76,310-4.
18. Scrimshaw NS and SanGiovanni JP. Synergism of nutrition, infection and immunity: an overview. Am J Clin Nutr. 1997;66,S464Â· 77.