Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Rev Paul Pediatr. 2020;38:e2018333. doi: 10.1590/1984-0462/2020/38/2018333. Epub 2020 May 8.
To describe the clinical profile of children and adolescents hospitalized with community-acquired pneumonia (CAP). They were divided into two groups: those with and those without comorbidities.
An observational, cross-sectional, descriptive study with prospective data collection, was carried out in a cohort of patients aged zero to 11, who were hospitalized with a clinical and radiological diagnosis of community-acquired pneumonia, from January 2010 to January 2012. As an exploratory study, the two groups were compared through logistic regression for possible risk factors associated with community-acquired pneumonia. Relative risk (RR) was used with a 95% confidence interval (95%CI). The process of selection for independent variables was stepwise forward, with a significance level of 5%.
There were 121 cases of community-acquired pneumonia evaluated, and 47.9% had comorbidities. In the bivariate analysis, patients with comorbidities demonstrated higher chances for: age >60 months (p=0.005), malnutrition (p=0.002), previous use of antibiotics (p=0.008) and previous hospitalization for community-acquired pneumonia in the last 24 months (p=0.004). In the multivariate analysis, these variables were independent predictors of community-acquired pneumonia in patients with the comorbidities: age >60 months (p=0.002; RR=5.39; 95%CI 1.89-15.40); malnutrition (p=0.008; RR=1.75; 95%CI 1.75-44.60); previous use of antibiotics (p=0.0013; RR=3.03; 95%CI 1.27-7.20); and previous hospitalization for community-acquired pneumonia (p=0.035; RR=2.91; 95%CI 1.08-7.90).
Most patients with community-acquired pneumonia and comorbidities were aged >60 months, were malnourished, had used antibiotics and had been hospitalized for community-acquired pneumonia. Comorbidities were associated with a higher chance of malnutrition and hospitalizations for community-acquired pneumonia in an older age group, compared to children without comorbidities. Knowledge of this clinical profile may contribute to better assist pediatric patients with community-acquired pneumonia hospitalized in referral centers.
描述因社区获得性肺炎（CAP）住院的儿童和青少年的临床特征。这些患者分为伴有和不伴有合并症的两组。
这是一项观察性、横断面、描述性研究，前瞻性地收集数据，纳入了 2010 年 1 月至 2012 年 1 月因临床和影像学诊断为社区获得性肺炎住院的零至 11 岁患者队列。作为一项探索性研究，通过逻辑回归比较两组可能与社区获得性肺炎相关的危险因素。使用相对风险（RR）和 95%置信区间（95%CI）。选择自变量的过程采用逐步向前法，显著水平为 5%。
共评估了 121 例社区获得性肺炎患者，其中 47.9%有合并症。在单变量分析中，有合并症的患者年龄>60 个月（p=0.005）、营养不良（p=0.002）、近期使用抗生素（p=0.008）和过去 24 个月因社区获得性肺炎住院（p=0.004）的几率更高。在多变量分析中，这些变量是伴有合并症的患者发生社区获得性肺炎的独立预测因素：年龄>60 个月（p=0.002；RR=5.39；95%CI 1.89-15.40）；营养不良（p=0.008；RR=1.75；95%CI 1.75-44.60）；近期使用抗生素（p=0.0013；RR=3.03；95%CI 1.27-7.20）；和过去因社区获得性肺炎住院（p=0.035；RR=2.91；95%CI 1.08-7.90）。
大多数伴有合并症的社区获得性肺炎患者年龄>60 个月，营养不良，使用过抗生素，曾因社区获得性肺炎住院。与无合并症的儿童相比，伴有合并症的儿童和青少年年龄较大，营养不良和因社区获得性肺炎住院的几率更高。了解这种临床特征可能有助于更好地为在转诊中心住院的患有社区获得性肺炎的儿科患者提供帮助。
