Background: Pneumonia is the leading cause of death among children and its severity is variable. Risk factors predicting CAP severity in children have not been established in the developed world. The aim of the study was to determine risk factors necessitating PICU admission among children with CAP.
Methods: This was a prospective, population based study in children 1. Two groups were compared with children admitted to PICU (PICU-CAP): 1) Children treated in the ED (ED-CAP); and 2) hospitalized children (Hosp-CAP).
Results: Overall, 9,722 episodes were evaluated: 198 (2.0%) PICU-CAP, 5,703 (65.7%) Hosp-CAP and 3,821 (39.3%) ED-CAP. The following risk factors were significant for PICU-CAP vs. Hosp-CAP and ED-CAP: young age, Bedouin ethnicity, congenital heart disease, lower temperature, hypoxemia, lower leukocytes and neutrophils counts and higher urea. A viral etiology, mainly RSV, was more common in children admitted to PICU (TABLE). Further analysis will be carried out to determine independent risk factors.
Conclusions: Young age, Bedouin origin, underlying medical conditions, hypoxemia, dehydration, lower inflammatory response and higher rate of viral infection were risk factors for a child with CAP to be admitted to PICU. These risk factors may be used for identify high risk children admitted to the hospital with CAP.
References
- WHO. World Health Organization Pneumonia Vaccine Trial Investigator's Group. Standardization of interpretation of chest radiographs for the diagnosis of pneumonia in children. WHO/V&B/01.35: World Health Organization, Geneva. 2001. http://www.who.int/vaccine_research/documents/en/pneumonia_children.pdf.
