Risk Factors for Mortality in Children with Hospital-Acquired Pneumonia in Dr. Soetomo General Hospital Surabaya
Downloads
Introduction: Hospital-Acquired Pneumonia (HAP) is a nosocomial pneumonia that brings negative impacts, such as prolonged hospital stay and increased cost. Previous studies often discussed about the risk factors of HAP mortality in adult patients rather than in children. This study aimed to analyze the risk factors of mortality in children with HAP.
Methods: This was a retrospective observational analytic study using cross sectional method with total sampling. A total of 73 children were enrolled in this study, consisted of inpatients at Pediatric Inpatient Room Dr. Soetomo General Hospital Surabaya who met the inclusion and exclusion criteria. Independent variables were gender, age, onset of HAP, length of stay (LOS), comorbidities, birth weight, type of breastfeeding, the use of mechanical ventilation (MV), and response to therapy. Dependent variable was mortality. The data were collected from medical records, which later were analyzed by bivariate and multivariate analysis.
Results: The mortality of children with HAP was 23.3%. Bivariate analysis showed that age (p = 0.009), the use of MV (p = 0.029), and response to therapy (p = 0.036) were proven to affect mortality in children with HAP in Dr. Soetomo General Hospital Surabaya. In addition, the use of MV was the significant risk factor (p = 0.023) given by the multivariate analysis. Gender, onset of HAP, LOS, comorbidities, and type of breastfeeding were not proven to be the risk factors for mortality.
Conclusion:Mortality in children with HAP in Dr. Soetomo General Hospital Surabaya was significantly affected by children's age, the use of MV, and response to therapy. This information might be used as early signs and treatment strategies for children with HAP which lead to the decrease of hospital mortality.
WHO. Pneumonia. Geneva, https://www.who.int/ en/news-room/fact-sheets/detail/pneumonia (2019, accessed 24 January 2021).
Society AT, America IDS of. Guidelines for the Management of Adults with Hospital-Acquired, Ventilator-Associated, and Healthcare-Associated Pneumonia. Am J Respir Crit Care Med 2005; 171: 388–416.
Leone M, Bouadma L, Bouhemad B, et al. Hospital-Acquired Pneumonia in ICU. Anaesthesia, Crit care pain Med 2018; 37: 83–98.
Zar HJ, Cotton MF. Nosocomial Pneumonia in Pediatric Patients: Practical Problems and Rational Solutions. Pediatr Drugs 2002; 4: 73–83.
Foglia E, Meier MD, Elward A. Ventilator-Associated Pneumonia in Neonatal and Pediatric Intensive Care Unit Patients. Clin Microbiol Rev 2007; 20: 409–25, table of contents.
Bigham MT, Amato R, Bondurrant P, et al. Ventilator-Associated Pneumonia in the Pediatric Intensive Care Unit: Characterizing the Problem and Implementing a Sustainable Solution. J Pediatr 2009; 154: 582-587.e2.
Mansour MGE, Bendary S. Hospital-Acquired Pneumonia in Critically Ill Children: Incidence, Risk Factors, Outcome and Diagnosis with Insight on the Novel Diagnostic Technique of Multiplex Polymerase Chain Reaction. Egypt J Med Hum Genet 2012; 13: 99–105.
Sangmuang P, Lucksiri A, Katip W. Factors Associated with Mortality in Immunocompetent Patients with Hospital-acquired Pneumonia. J Glob Infect Dis 2019; 11: 13–18.
Lee S-C, Hua C-C, Yu T-J, et al. Risk Factors of Mortality for Nosocomial Pneumonia: Importance of Initial Anti-Microbial Therapy. Int J Clin Pract 2005; 59: 39–45.
WHO. Pocket Book of Hospital Care for Children: Guidelines for the Management of Common Illnesses with Limited Resources. Geneva: WHO Press, 2005.
WHO. International Statistical Classification of Diseases and Related Health Problems: 10th revision. 2nd ed. Geneva: World Health Organization, 2004.
Akanmode AM, Mahdy H. Macrosomia. Treasure Island (FL), 2021.
WHO. WHO | The World Health Organization's Infant Feeding Recommendation.
Barbagelata E, Cillóniz C, Dominedò C, et al. Gender Differences in Community-Acquired Pneumonia. Minerva Med 2020; 111: 153–165.
Arnold FW, Wiemken TL, Peyrani P, et al. Outcomes in Females Hospitalised with Community-Acquired Pneumonia are Worse than in Males. Eur Respir J 2013; 41: 1135–1140.
López-de-Andrés A, Albaladejo-Vicente R, de Miguel-Diez J, et al. Gender Differences in Incidence and In-Hospital Outcomes of Community-Acquired, Ventilator-Associated and Nonventilator Hospital-Acquired Pneumonia in Spain. Int J Clin Pract 2021; 75: e13762.
Pessoa E, Bárbara C, Viegas L, et al. Factors Associated with In-Hospital Mortality from Community-Acquired Pneumonia in Portugal: 2000-2014. BMC Pulm Med 2020; 20: 18.
Said M. Pneumonia. In: Rahajoe NN, Supriyatno B, Setyanto DB (eds) Buku Ajar Respirologi Anak. Jakarta: Badan Penerbit IDAI, 2008, p. 350.
Ferdous F, Ahmed S, Das SK, et al. Pneumonia Mortality and Healthcare Utilization in Young Children in Rural Bangladesh: A Prospective Verbal Autopsy Study. Trop Med Health 2018; 46: 1–10.
Lamberti LM, Zakarija-Grković I, Fischer Walker CL, et al. Breastfeeding for Reducing the Risk of Pneumonia Morbidity and Mortality in Children under Two: A Systematic Literature Review and Meta-Analysis. BMC Public Health 2013; 13 Suppl 3: S18.
Siempos II, Vardakas KZ, Kyriakopoulos CE, et al. Predictors of Mortality in Adult Patients with Ventilator-Associated Pneumonia: A Meta-Analysis. Shock 2010; 33: 590–601.
Inchai J, Pothirat C, Bumroongkit C, et al. Prognostic Factors Associated with Mortality of Drug-Resistant Acinetobacter baumannii Ventilator-Associated Pneumonia. J Intensive Care 2015; 3: 9.
Brown N. How Should Very Low Birthweight Babies Best be Managed in Papua New Guinea? P N G Med J 1996; 12–15.
Diallo FB, Bell L, Moutquin J-M, et al. The Effects of Exclusive Versus Non-Exclusive Breastfeeding on Specific Infant Morbidities in Conakry (Guinea). PAMJ 2009; 22. Epub ahead of print 2009. DOI: 10.11604/PAMJ.2009.2.2.51.
Rudan I, Boschi-Pinto C, Biloglav Z, et al. Epidemiology and Etiology of Childhood Pneumonia. Bull World Health Organ 2008; 86: 408–416.
Folic N, Djordjevic Z, Folic M, et al. Hospital-Acquired Pneumonia in Newborns with Birth Weight Less than 1500 Grams: Risk Factors and Causes. Serbian J Exp Clin Res 2016; 17: 327–332.
Bokade C, Madhura A, Bagul A, et al. Predictors of Mortality in Children due to Severe and Very Severe Pneumonia. Niger Med J 2015; 56: 287.
Ramachandran P, Nedunchelian K, Vengatesan A, et al. Risk Factors for Mortality in Community Acquired Pneumonia among Children Aged 1-59 Months Admitted in a Referral Hospital. Indian Pediatr 2012; 49: 889–895.
ZieliÅ„ska M, ZleliÅ„ski S, ͆niatkowska-Bartkowska A. Mechanical Ventilation in Children-Problems and Issues. Adv Clin Exp Med 2014; 23: 843–848.
Jakhar SK, Pandey M, Shah D, et al. Etiology and Risk Factors Determining Poor Outcome of Severe Pneumonia in Under–Five Children. Indian J Pediatr 2018; 85: 20–24.
1. The journal allows the author to hold the copyright of the article without restrictions.
2. The journal allows the author(s) to retain publishing rights without restrictions.
3. The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution Share-Alike (CC BY-SA).
4. The Creative Commons Attribution Share-Alike (CC BY-SA) license allows re-distribution and re-use of a licensed work on the conditions that the creator is appropriately credited and that any derivative work is made available under "the same, similar or a compatible license”. Other than the conditions mentioned above, the editorial board is not responsible for copyright violation.
JR (