Articles

Determinants of Complicated Pneumonia in Hospitalized Pediatric Patients

Abstract

Pediatric complicated pneumonia (PCOMP) is the leading cause of mortality in children under the age of five. The study was conducted to determine the epidemiological and clinical characteristics of children with PCOMP. A retrospective study was carried out among all pediatric patients who were hospitalized due to complicated pneumonia in Abuzar Hospital (Ahvaz, Iran) during two years. The patients were evaluated in terms of epidemiological and clinical characteristics. A total of 65 hospitalized children and infants were identified. More than half of the patients were females (n=36; 55.3%). Their mean age was 4.21±3.80 years (range six months-15 years), and 64.1% of them (n=42) were under the age of five. There were 12 (19.4%) patients with failure to thrive (FTT). In addition, 58.5% of patients (n=38) had no history of hospitalization, and 66.2% of them (n=43) did not have any underlying disease. The mean length of hospital stay (LOS) was 12.46±6.85 (range 4-45) days. Admission was more common in winter (40%) and autumn (33.8%). Moreover, there were no significant associations between the types of complications and patients’ gender, age, FTT, and LOS. Further studies are warranted to identify factors contributing to disease severity and develop appropriate strategies for the prevention and treatment of PCOMP among Iranian children.

1. Bradley JS, Byington CL, Shah SS, Alverson B, Carter ER, Harrison C, et al. The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis 2011; 53:e25-76.
2. Sawicki GS, Lu FL, Valim C, Cleveland RH, Colin AA. Necrotising pneumonia is an increasingly detected complication of pneumonia in children. Eur Respir J 2008;31:1285-91.
3. Chibuk TK, Cohen E, Robinson JL, Mahant S, Hartfield DS, Canadian Paediatric Society. Paediatric complicated pneumonia: diagnosis and management of empyema. Paediatr Child Health 2011;16:425-7.
4. Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood pneumonia. Bull World Health Organ 2008;86:408-16.
5. Witt WP, Weiss AJ, Elixhauser A. Overview of hospital stays for children in the United States, 2012: Statistical Brief #187. Rockville, MD: Agency for Healthcare Research and Quality, 2014.
6. Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, et al. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet 2012;379:2151-61.
7. Van Hemelrijck MJ, Lindblade KA, Kubaje A, Hamel MJ, Odhiambo F, Phillips‐Howard PA, et al. Trends observed during a decade of paediatric sick visits to peripheral health facilities in rural western Kenya, 1997–2006. Trop Med Int Health 2009; 14:62-9.
8. Wonodi CB, Deloria-Knoll M, Feikin DR, DeLuca AN, Driscoll AJ, Moïsi JC, et al. Evaluation of risk factors for severe pneumonia in children: the Pneumonia Etiology Research for Child Health study. Clin Infect Dis 2012;54:S124-31.
9. Haji T, Byrne A, Kovesi T. Trends in pediatric complicated pneumonia in an Ontario local health integration network. Children (Basel) 2018;5:36.
10. Tracy MC, Mathew R. Complicated pneumonia: current concepts and state of the art. Curr Opin Pediatr 2018;30:384-92.
11. Zabihullah R, Dhoubhadel BG, Rauf FA, Shafiq SA, Suzuki M, Watanabe K, et al. Risk for death among children with pneumonia, Afghanistan. Emerg Infect Dis 2017;23:1404.
12. Brito RD, Guerra TC, Câmara LD, Mattos JD, Mello MJ, Correia JD, et al. Clinical characteristics and outcomes of acute community acquired pneumonia in children at a reference public hospital in Pernambuco State, Brazil (2010-2011). Rev Bras Saude Mater Infant 2016;16:247-57.
13. Lima EJ, Mello MJ, Albuquerque MF, Lopes MI, Serra GH, Abreu-Lima MA, et al. Clinical and epidemiological characteristics of severe community-acquired pneumonia in children after introduction of the 10-valent pneumococcal vaccine. Pediatric Health Med Ther 2015;6:131-8.
14. Ma YJ, Wang SM, Cho YH, Shen CF, Liu CC, Chi H, et al. Clinical and epidemiological characteristics in children with community-acquired mycoplasma pneumonia in Taiwan: A nationwide surveillance. J Microbiol Immunol Infect 2015;48:632-8.
15. Elemraid MA, Thomas MF, Blain AP, Rushton SP, Spencer DA, Gennery AR, Clark JE, North East of England Pediatric Respiratory Infection Study Group Newcastle upon Tyne, UK. Risk factors for the development of pleural empyema in children. Pediatr Pulmonol 2015;50:721-6.
16. Mustufa MA, Korejo R, Shahid A, Nasim S. Infection remains a leading cause of neonatal mortality among infants delivered at a tertiary hospital in Karachi, Pakistan. J Infect Dev Ctries 2014;8:1470-5.
17. Wang XF, Liu JP, Shen KL, Ma R, Cui ZZ, Deng L, et al. A cross-sectional study of the clinical characteristics of hospitalized children with community-acquired pneumonia in eight eastern cities in China. BMC Complement Altern Med 2013;13:367.
18. Huang CY, Chang L, Liu CC, Huang YC, Chang LY, Huang YC, et al. Risk factors of progressive community-acquired pneumonia in hospitalized children: A prospective study. J Microbiol Immunol Infect 2015;48:36-42.
19. Ghadiri K, Ahmadi M, Mohammadi A, Rezaei M, Mokhtari T, Heshmati F, et al. Evaluation of Pneumonia in under 5 years old children in Imam Reza Hospital during 2006-2010. JCRPs 2013;2:137-46.
20. Hackshaw, A. Small studies: strengths and limitations. Eur Respir J 2008;32:1141-43.
21. Mirkarimi M, Alisamir M, Saraf S, Heidari S, Barouti S, Mohammadi S. Clinical and Epidemiological Determinants of Lower Respiratory Tract Infections in Hospitalized Pediatric Patients. Int J Pediatr 2020;2020:8844420.
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IssueVol 59, No 3 (2021) QRcode
SectionArticles
DOI https://doi.org/10.18502/acta.v59i3.5786
Keywords
Complicated pneumonia Pediatrics Children Iran Ahvaz

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How to Cite
1.
Mirkarimi M, Alisamir M, Nasiri P, Barouti S, Mohammadi S. Determinants of Complicated Pneumonia in Hospitalized Pediatric Patients. Acta Med Iran. 2021;59(3):155-160.