Turkish Journal of Pediatric Disease

Abstract

Objective: Childhood pneumonias are the most important mortality and morbidity reasons especially in developing countries. In this study, demographic attributes and important risk factors among children hospitalized with pneumonia were examined; their effects on complications and prognosis were evaluated.

Material and Methods: In this retrospective cross-sectional study, children diagnosed with pneumonia and hospitalized between January 2017- January 2018 in Pediatric Services and Intensive Care Unit (ICU) were evaluated. How factors such as demographic findings, nutrition (breast milk), presence of malnutrition, vaccination history, presence of chronic disease, crowded living conditions, passive smoking affected hospitalization and its duration; development of complications after the disease and survival findings were examined.

Results: Among 289 hospitalized patients, 53.3% were female, median age was 14 months and 65.4% of the patients were under 2 years old. Nineteen point seven percent of the patients had premature birth history, 76.1% of them had >2500 gr birth weight. It was determined from the postnatal histories that 15.9% of them required incubator care, 6.2% of them required mechanical ventilator. Among the patients, it was found out that 31.5% of the patients did not receive breast milk, 10% had malnutrition, 18% had incomplete vaccination, 26.6% were exposed to passive smoking, 37% had a chronic disease. The most common symptoms observed during the admission were cough (86.5%) and fever (60%), median symptom period was 3 days. The most common physical examination findings detected were tachypnea (68.9%) and retractions (60.9%). In their radiological evaluations, it is detected that 85.8% of the patients had pneumonic infiltration, 3,5% had lobar consolidation, 2.8% had pneumonic infiltration+pleural effusion, 2.1% had pneumonic infiltration+atelectasis, 1.1% had lober consolidation+pleural effusion and 0.3% had atelectasis. During their stay in the hospital, microorganisms could be detected in 9% of the culture samples taken from the patients. Fifty six point sevent percent of the patients received mono antibiotic therapy while the rest of them received combined antibiotic therapy. Median hospitalization period was 9 days (1-115 days) and 25.6% of the patients required ICU monitoring. Complication development rate of the patients in the course of pneumonia detected as 13.1%. Age, premature birth history, low birth weight, staying in the incubator or in mechanical ventilator during the postnatal period, presence of malnutrition, presence of chronic disease, tachypnea, retraction, fever, rale-ronchus parameters during physical examinations at the admission, presence of pneumonic infiltration or lobar consolidation with pleural effusion on the chest x-ray, were determined as the parameters affecting prolonged hospitalization, complication development in the follow-up and in ICU stay.

Conclusion: Being under 2 years of age, prematurity, low birth weight, absence of breast milk, incomplete vaccination and malnutrition are the significant risk factors for pneumonia dependent hospitalizations among children. Presence of additional neurological and genetic diseases and low oxygen saturation are identified as the factors impacting the need to stay in intensive care unit, length of stay and complications. Identifying and preventing the risk factors affecting course of the disease and the prognosis, its complications and hospitalization period will reduce the morbidity of the pneumonias in childhood.