Risk factors associated with morbidity and mortality of pneumonia in Thai children under 5 years.
ARI is the most common cause of illness and death in children under 5 years of age. Pneumonia is the leading cause of death. This prospective study was part of an ARIC project conducted to identify risk factors associated with mortality and morbidity of community acquired pneumonia in Thai children younger than 5 years of age. Study subjects were 267 moderately severe pneumonia who were admitted to hospital. Fifteen percent required a ventilator and were categorized as severe cases. Nine patients (3.4%) died and were categorized in the fatal group. From univariate analysis only, risk factors of fatal pneumonia were lower body weight (p = 0.04), paternal age less than 35 year (OR = 6.1, p = 0.01), underlying heart disease (OR = 12.1, p = 0.0000) and protein energy malnutrition (OR = 7.9, p = 0.0087). Predictors on admission to predict fatal outcome were rapid respiratory rate > 50/minute (OR = 4.1, p = 0.03), gallop rhythm (OR = 11, p = 0.04), enlarged liver (OR = 13.2, p = 0.001), and cyanosis (OR = 12, p = 0.0006). Significant factors associated with severe pneumonia after multiple logistic regression were underlying heart disease (OR = 4.04, 95% CI 1-15.4), enlarged liver (OR = 4.31, 95% CI 1.2-15.2) and cyanosis (OR = 5, 95% CI 0.8-28.7). This information should create awareness in physicians who are responsible for young children with pneumonia. Early recognition and intervention may prevent deaths and complications.(ABSTRACT TRUNCATED AT 250 WORDS)
Suwanjutha
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S
Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Ruangkanchanasetr
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S
Chantarojanasiri
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T
Hotrakitya
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S
D000367:Age Factors; D000704:Analysis of Variance; D002423:Cause of Death; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D009017:Morbidity; D016017:Odds Ratio; D011014:Pneumonia / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D011159:Population Surveillance; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013785:Thailand / Q000453:epidemiology