title: Predictors of mortality in children due to severe and very severe pneumonia.
abstract: BACKGROUND
  Mortality due to pneumonia in children is more than any other illness. Limited data is available to predict mortality in children with pneumonia from central India.
  
  
  OBJECTIVE
  To study predictors of mortality in children aged 1-59 months hospitalised with severe and very severe pneumonia.
  
  
  METHODS
  Present study was observational longitudinal study that was done in a tertiary care hospital of central India. Two hundred and ninety children, aged 1-59 months, presented with severe and very severe pneumonia were enrolled in this study. Outcome and predictors of mortality were studied. Data was analysed with Chi-square test, univariate and multivariate regression analysis.
  
  
  RESULTS
  Out of 270 enrolled study subjects, maximum (108, 37.24%) were belonged to 1-6-months age group. Proportion of mortality was maximum (16, 64.00%) in that age group. Overall case fatality rate was 8.62%. Among significant variables, delayed hospital referral [adjusted odds ratio (OR)-52.09, 95% confidence interval (CI)- 6.74-402.39], incomplete immunisation (OR-12.28, 95% CI-2.15-69.93), severe malnutrition (Z score < -3) (OR-15.51, 95% CI- 2.04-117.83), refusal to feed (OR- 30.57, 95% CI- 2.47-378.26), and hypoglycaemia (OR- 6.98, 95% CI- 1.05-46.30) were found significant independently on multivariate regression analysis.
  
  
  CONCLUSIONS
  Delayed hospital referral, incomplete immunisation, severe malnutrition, refusal to feed, and hypoglycaemia were independent predictors of mortality in children with severe and very severe pneumonia.
authors.affiliation: Department of Pediatrics, Government Medical College, Nagpur, Maharashtra, India.
authors.forename: Chandrakant M
authors.initials: CM
authors.lastname: Bokade
authors.affiliation: Department of Pediatrics, Government Medical College, Nagpur, Maharashtra, India.
authors.forename: Abhishek D
authors.initials: AD
authors.lastname: Madhura
authors.affiliation: Department of Pediatrics, Government Medical College, Nagpur, Maharashtra, India.
authors.forename: Abhay S
authors.initials: AS
authors.lastname: Bagul
authors.affiliation: Department of Community Medicine, Government Medical College, Nagpur, Maharashtra, India.
authors.forename: Subhash B
authors.initials: SB
authors.lastname: Thakre
keywords: Children; mortality; predictors; severe pneumonia; very severe pneumonia