Risk factors associated with severe viral croup in hospitalised Malaysian children.
OBJECTIVE
To determine the risk factors associated with severe viral croup in hospitalised Malaysian children.


METHODS
The medical records of children aged less than five years admitted with a diagnosis of viral croup between 1994 and 1999 were reviewed. Severe viral croup was diagnosed in children who had stridor at rest with marked recession associated with central cyanosis or altered level of consciousness. Multivariate logistic regression analysis was performed to identify risk factors associated with severe viral croup.


RESULTS
Eighteen (14.7%) of 122 children with viral croup were severe. These children were older (mean age 16.8 +/- 7.2 vs 12.6 +/- 6.6 months, p = 0.01) and had a shorter duration of illness prior to admission (1.7 +/- 0.7 days vs 2.3 +/- 1.4 days, p = 0.03). Age between 12 and 24 months (OR 3.8 95% Cl 1.3, 12.7, p = 0.02) and fever (OR 5.7 95% Cl 2.9, 15.6, p = 0.02) were the only risk factors associated with severe viral croup after multivariate logistic regression analysis. Only three children or 2.5 per 100 children admitted with viral croup required ventilation.


CONCLUSIONS
Only a small number of children admitted particularly those between 12 to 24 months with fever developed severe viral croup. Recognition of these risk factors provides a guide in selecting children who will most likely benefit from steroid therapy. The overall outcome was nonetheless favourable.
Chan
P W K
PW
Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur, Malaysia. patrick@ummc.edu.my
D000402:Airway Obstruction / Q000453:epidemiology / Q000209:etiology* / Q000821:virology; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014777:Virus Diseases / Q000453:epidemiology / Q000209:etiology*