title: Risk factors for local complications in children with community-acquired pneumonia.
abstract: OBJECTIVE
  The aim of this study was to evaluate the factors that could predict the development of local complications (parapneumonic effusion/pleural empyema, necrotizing pneumonia, and lung abscess) in children with community-acquired pneumonia (CAP).
  
  
  METHODS
  Demographic, clinical, and laboratory data were prospectively collected and compared in children with noncomplicated and complicated CAP.
  
  
  RESULTS
  Two-hundred and three patients aged from 2 months to 17 years were enrolled. There were 141 and 62 children with noncomplicated and complicated CAP, respectively. Significantly longer duration of fever and a higher level of acute phase reactants were demonstrated in complicated when noncomplicated to complicated CAP. Asymmetric chest pain as well as prehospital treatment with ibuprofen and acetaminophen were significantly more common in patients with complicated CAP (P < .001, P = .02 and P = .003, respectively). Preadmission cumulative dose of ibuprofen exceeding 78.3 mg/kg (median dose for the entire group) was associated with 2.5-fold higher odds ratio (OR) for CAP complications [OR 2.54 CI (1.31-4.94); P = .008)]. In contrast, pneumococcal vaccination was associated with lower odds ratio [OR.03 CI (.23-.89); P = .03] for local complications.
  
  
  CONCLUSIONS
  Some clinical and laboratory data including chest pain, longer duration of fever, higher acute phase reactants, and especially preadmission treatment with ibuprofen or acetaminophen were associated with local complications of CAP. The results of this study highlight the association between the dose of ibuprofen and local CAP complications.
authors.affiliation: Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Krenke
authors.affiliation: Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Marta
authors.initials: M
authors.lastname: Krawiec
authors.affiliation: Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Grażyna
authors.initials: G
authors.lastname: Kraj
authors.affiliation: Department of Epidemiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Peradzynska
authors.affiliation: Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Krauze
authors.affiliation: Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Kulus
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000150:complications*; D016724:Empyema, Pleural / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D008169:Lung Abscess / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D016017:Odds Ratio; D010996:Pleural Effusion / Q000453:epidemiology / Q000209:etiology*; D011014:Pneumonia / Q000150:complications*; D011044:Poland / Q000453:epidemiology; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors
keywords: children; ibuprofen; parapneumonic effusion; pleural empyema; pneumonia