Critical illness related to community acquired pneumonia, its epidemiology and outcomes in a pediatric intensive care unit of Pakistan.

Abstract

BACKGROUND\nTo determine the epidemiology and outcomes in critically ill children admitted with severe community acquired pneumonia (CAP) and to identify risk factors associated with mortality in a pediatric intensive care (PICU) METHODS: Retrospective review of medical records of all children (age one month - 18 years) admitted to PICU with CAP from January 2013 to March 2018 was done. Patients admitted in last two weeks before current illness and those with bronchiolitis (based on clinical diagnosis) were excluded. Data was collected on a structured proforma and included demographic, clinical data, comorbidities, therapeutic information, laboratory data and outcome data. Results were presented as mean with standard deviation and frequency with percentages. Factors associated with mortality were analyzed, using logistic regression for both Univariate and multivariate analyses.\n\n\nRESULTS\n187 children with severe CAP were identified, 53.5% (n= 100) were less than one year of age and 65.2% (n= 122) were male, 32.6 % (n= 61) were underweight, and 24.6 % (n= 46) were stunted. 94% (175) required mechanical ventilation. Mortality among the cohort was 20.3% (n=38) with median length of mechanical ventilation 4(2-8) days, and median Length of PICU stay was 6(4-12) days. PRISM score > 10 on admission, presence of systemic illness, empyema and length of PICU stay 14 (±2) days were associated with increased mortality among critically ill children admitted with CAP (p<0.05).\n\n\nCONCLUSIONS\nSevere illness on presentation, presence of systemic illness and empyema are associated with increased mortality in children admitted to the PICU with severe CAP. This article is protected by copyright. All rights reserved.