RISK FACTORS OF COMPLICATED COMMUNITY-ACQUIRED PNEUMONIA IN CHILDREN:
1-YEAR DATA FROM A TERTIARY HEALTHCARE CENTER
Abstract
Introduction:Community-acquired pneumonia(CAP) in children has tended to
decrease in recent years with effective vaccination and
treatments.However,the frequency of complicated community-acquired
pneumonia (CCAP) is gradually increasing.By determining risk factors for
the development of CCAP,new approaches for early diagnosis and effective
treatment can be determined. Method: Records of 113 patients who were
hospitalized due to CAP and CCAP between January 2017 and December 2017
were examined.Demographic characteristics of the patients,comorbid
diseases,admission symptoms,physical examination findings,laboratory and
imaging results, treatments, hospital stay and treatment response were
recorded. Pleural effusion,if empyema developed in patients with
CCAP,thoracentesis and/or chest tube insertion,fibrinolytic therapy,and
the need for additional surgical intervention were investigated.
Results:Our patients had a mean age of 3.6 ± 2.2, 60(53%) were female
and 53(47%) were male.93 (82.3%) of the patients were diagnosed with
CAP and 18(15.9%) were diagnosed with CCAP.Detection of pleural
effusion at the admission of patients in multivariate logistic
regression[(OR (95% CI),4.24 (1.77-10.16), p <0.001)]
respiratory distress(tachypnea and retraction)[(OR (95% CI) 3.04
(1.30-7.130) ),p <0.001)] and hypoxia (92% and less saO2
measured by pulse oximeter) at admission [(OR (95% CI),: 5.247
(1.58-9.46),p <0.001)] were identified as independent risk
factors for diagnosis of CCAP. Discussion:Hypoxia,respiratory distress
and imaging pleural effusion are important distinguishing findings for
development of complications in patients admitted for CAP. Determining
the etiology of CCAPs and early diagnosis and treatment approaches can
be established, and protection measures can be taken. With future
prospective studies, the causes of CCAP can be determined and preventive
measures and new treatment approaches can be developed