Meliyanti Ari, Rusmawatiningtyas Desy, Makrufardi Firdian, Arguni Eggi
Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia.
Heliyon. 2021 May 18;7(5):e07063. doi: 10.1016/j.heliyon.2021.e07063. eCollection 2021 May.
Pneumonia is still a major cause of death and incurs significant morbidity and mortality in developing countries. Thus, patients care does not only focus on treatment but also identifying factors that associated with the patient's outcome. Therefore we defined factors associated with mortality in pediatric pneumonia and assessed the outcome of pneumonia supported by mechanical ventilation in children.
We performed cohort retrospective study by collecting data of pediatric pneumonia patients who admitted to Pediatric Intensive Care Unit (PICU) at Dr. Sardjito General Hospital, from 2014 to 2016. Chi square and multivariate logistic regression tests were used to analyze the variables: anemia, comorbidities, bacteremia, age between 1-6 months old, and underweight as associated factors for mortality.
One hundred and eleven children were included in this study. Those patients were diagnosed as community acquired pneumonia (79.3%), hospital acquired pneumonia (14.4%) and ventilator associated pneumonia (6.3%), with mortality rate 47.7%. Multivariate logistic regression analysis revealed that bacteremia, and underweight could be used as predictor factors of mortality for pediatric patients with pneumonia who were supported by mechanical ventilation with OR 2.5 (CI 95%: 1.03-6.1) and 2.4 (CI 95%: 1.1-5.7), respectively.
Factors associated with mortality for pediatric patients with pneumonia who were supported by mechanical ventilation were bacteremia and underweight. It is necessary to compare our findings with other centers.
在发展中国家，肺炎仍是主要的死亡原因，会导致显著的发病率和死亡率。因此，患者护理不仅关注治疗，还需识别与患者预后相关的因素。所以我们确定了小儿肺炎患者的死亡相关因素，并评估了小儿机械通气支持下肺炎的预后情况。
我们通过收集2014年至2016年期间入住萨迪托综合医院儿科重症监护病房（PICU）的小儿肺炎患者的数据进行队列回顾性研究。采用卡方检验和多因素逻辑回归分析来分析变量：贫血、合并症、菌血症、1至6个月龄、体重不足作为死亡的相关因素。
本研究纳入了111名儿童。这些患者被诊断为社区获得性肺炎（79.3%）、医院获得性肺炎（14.4%）和呼吸机相关性肺炎（6.3%），死亡率为47.7%。多因素逻辑回归分析显示，菌血症和体重不足可作为小儿机械通气支持下肺炎患者死亡的预测因素，其比值比分别为2.5（95%置信区间：1.03 - 6.1）和2.4（95%置信区间：1.1 - 5.7）。
小儿机械通气支持下肺炎患者的死亡相关因素是菌血症和体重不足。有必要将我们的研究结果与其他中心进行比较。
