title: Steroid use is associated with pneumonia in pediatric chest trauma.
abstract: A review of pediatric trauma focused on pediatric chest injuries was performed at a trauma center specializing in neurologic trauma. Eighty of 342 (23%) pediatric trauma patients admitted to the center had chest injuries. Age, gender, mechanism of injury, magnitude of injury, incidence of pulmonary infection, chest tube usage, endotracheal intubation, steroid or antibiotic usage, morbidity, and mortality data were reviewed. Sixteen of 78 children (20%) with chest injuries developed pulmonary infections and were compared with the noninfected group. Patients with pneumonia had a higher morbidity with significantly longer mean hospital stay (43.0 vs. 12.7 days; p = 0.001), duration of intubation (8.4 vs. 1.5 days; p = 0.001), and total days with chest tubes, (2.2 vs. 1.4 days; p = 0.02). Pneumonia was significantly associated with longer mean duration of steroid usage (6.4 vs. 0.8 days; p = 0.0001). Duration of steroid administration for the treatment of concomitant brain injury was a significant independent risk factor for the occurrence of pneumonia.
authors.affiliation: Saint Joseph Hospital and Medical Center, Phoenix, Arizona.
authors.forename: M D
authors.initials: MD
authors.lastname: Williams
authors.forename: P E
authors.initials: PE
authors.lastname: Reckard
authors.forename: R
authors.initials: R
authors.lastname: Knox
authors.forename: S R
authors.initials: SR
authors.lastname: Petersen
authors.forename: W R
authors.initials: WR
authors.lastname: Schiller
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D011014:Pneumonia / Q000139:chemically induced*; D012307:Risk Factors; D013898:Thoracic Injuries / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology
chemical_list: D000305:Adrenal Cortex Hormones