Deivanayagam N, Nedunchelian K, Ramasamy S, Ratnam S R
Clinical Epidemiology Unit (CEU), Institute of Child Health, Egmore, Madras.
Indian Pediatr. 1992 Dec;29(12):1529-32.
We conducted a case control study to identify the risk factors for death among hospitalized children with acute pneumonia at the Institute of Child Health, Madras. All the 70 patients who died of pneumonia constituted the case--patients and 140 children recovered from pneumonia, selected by systematic sampling, during the same period served as controls. By univariate analysis, the risk factors for death in pneumonia observed were associated illnesses--Odds Ratio (OR) 22.2. (95% confidence interval [CI] 9.8-51.4; p = < 0.001); congenital anomalies--OR 10.4 (2.9-37.8; p = < 0.001); severe pneumonia--OR 4.2 (1.2-14.4; p = 0.09); marasmic status--OR 2.9 (1.5-5.7; p = 0.001); age under 6 months--OR 2.8 (1.3-5.7; p = 0.004); and severity of the pneumonia (lobar versus segmental)--OR 2.0 (0.9-4.5; p = 0.09). By logistic regression analysis the following risk factors were significant--associated illnesses. (51.6; 18-146.9; p = < 0.001); age under 6 months (6.5; 2-20.6; p = < 0.001), marasmic status (5.8; 2.2-15.6; p = < 0.001); and congenital anomalies (3.8; 2.0-7.1; p = < 0.001). These risk factors should be kept in mind by the clinicians for appropriate intervention at an earlier stage to minimize death.
我们在马德拉斯儿童健康研究所开展了一项病例对照研究，以确定住院急性肺炎患儿的死亡风险因素。所有70例死于肺炎的患者构成病例组，同期通过系统抽样选取的140例肺炎康复患儿作为对照组。单因素分析显示，观察到的肺炎死亡风险因素包括合并症（比值比[OR] 22.2，95%置信区间[CI] 9.8 - 51.4；p = < 0.001）、先天性异常（OR 10.4，2.9 - 37.8；p = < 0.001）、重症肺炎（OR 4.2，1.2 - 14.4；p = 0.09）、消瘦状态（OR 2.9，1.5 - 5.7；p = 0.001）、6个月以下年龄（OR 2.8，1.3 - 5.7；p = 0.004）以及肺炎严重程度（大叶性肺炎与节段性肺炎）（OR 2.0，0.9 - 4.5；p = 0.09）。多因素逻辑回归分析显示，以下风险因素具有统计学意义：合并症（51.6，18 - 146.9；p = < 0.001）、6个月以下年龄（6.5，2 - 20.6；p = < 0.001）、消瘦状态（5.8，2.2 - 15.6；p = < 0.001）以及先天性异常（3.8，2.0 - 7.1；p = < 0.001）。临床医生应牢记这些风险因素，以便在早期进行适当干预，将死亡风险降至最低。
