title: Predictors of death in infants hospitalized with pertussis: a case-control study of 16 pertussis deaths in Canada.
abstract: OBJECTIVE
  To describe the clinical course of fatal cases of pertussis and identify predictors of death at the time of presentation for medical care.
  
  
  METHODS
  Case-control study of 16 deaths from pertussis identified by the Immunization Monitoring Program, Active (IMPACT) surveillance network (January 1991-December 2001) matched with 32 nonfatal cases by age, date, and geography. Differences were compared by Fisher exact test and logistic regression. A multivariate model was developed using stepwise logistic regression.
  
  
  RESULTS
  All 16 fatal cases were < or =6 months old; 13 were <2 months old. Fatal cases were less likely to have had cough complications during pregnancy (48% vs 14%; P=.046) and more likely to have pneumonia (63% vs 16%; P=.0024) before hospital admission and more likely to have seizures, pneumonia, leukocytosis, and hypoxemia after admission (P<.001 for all comparisons). White blood cell count and pneumonia were independent predictors of fatal outcome in the multivariate model.
  
  
  CONCLUSIONS
  Infants too young to have begun their immunizations are at highest risk of fatal pertussis infection. Leukocytosis and pneumonia are predictors of a poor outcome; however, rapid progression of the disease may make interventions difficult.
authors: Lynda K
authors: LK
authors: Mikelova
authors: Scott A
authors: SA
authors: Halperin
authors: David
authors: D
authors: Scheifele
authors: Bruce
authors: B
authors: Smith
authors: Elizabeth
authors: E
authors: Ford-Jones
authors: Wendy
authors: W
authors: Vaudry
authors: Taj
authors: T
authors: Jadavji
authors: Barbara
authors: B
authors: Law
authors: Dorothy
authors: D
authors: Moore
mesh_terms: D001942:Breast Feeding / Q000706:statistics & numerical data; D002170:Canada / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010567:Pertussis Vaccine / Q000008:administration & dosage; D011446:Prospective Studies; D015996:Survival Rate; D014611:Vaccination / Q000706:statistics & numerical data; D014917:Whooping Cough / Q000401:mortality* / Q000517:prevention & control
chemical_list: D010567:Pertussis Vaccine