Clinical risk factors of death from pneumonia in children with severe acute malnutrition in an urban critical care ward of Bangladesh

Risks of death are high when children with pneumonia also have severe acute malnutrition (SAM) as a co-morbidity. However, there is limited published information on risk factors of death from pneumonia in SAM children. We evaluated clinically identifiable factors associated with death in under-five...

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Published in:PloS one 2013-09, Vol.8 (9), p.e73728-e73728
Main Authors: Chisti, Mohammod Jobayer, Salam, Mohammed Abdus, Ashraf, Hasan, Faruque, Abu S G, Bardhan, Pradip Kumar, Hossain, Md Iqbal, Shahid, Abu S M S B, Shahunja, K M, Das, Sumon Kumar, Imran, Gazi, Ahmed, Tahmeed
Format: Article
Language:English
Subjects:
Acute Disease
Antibiotics
Bangladesh - epidemiology
Blood
Blood transfusion
Caregivers
Case-Control Studies
Child Nutrition Disorders - epidemiology
Child, Preschool
Children
Comorbidity
Critical care
Critical Care - statistics & numerical data
Death
Dehydration
Diarrhea
Diarrhea - epidemiology
Diarrhea - therapy
Distension
Edema
Family medical history
Female
Food
Food supply
Health risks
Hospitals
Hospitals, Urban
Humans
Hypotension
Hypoxemia
Infant
Infant, Newborn
Intensive Care Units - statistics & numerical data
Logistic Models
Lungs
Male
Malnutrition
Management
Medical research
Mercury
Morbidity
Mortality
Nutrition
Parenteral nutrition
Pediatrics
Physiology
Pneumonia
Pneumonia - epidemiology
Pneumonia - mortality
Pneumonia - therapy
Regression analysis
Risk analysis
Risk Factors
Risk management
Sepsis
Survival Rate
Transfusion
Treatment Outcome
Vomiting
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Summary:Risks of death are high when children with pneumonia also have severe acute malnutrition (SAM) as a co-morbidity. However, there is limited published information on risk factors of death from pneumonia in SAM children. We evaluated clinically identifiable factors associated with death in under-five children who were hospitalized for the management of pneumonia and SAM. For this unmatched case-control design, SAM children of either sex, aged 0-59 months, admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) during April 2011 to July 2012 with radiological pneumonia were studied. The SAM children with pneumonia who had fatal outcome constituted the cases (n = 35), and randomly selected SAM children with pneumonia who survived constituted controls (n = 105). The median (inter-quartile range) age (months) was comparable among the cases and the controls [8.0 (4.9, 11.0) vs. 9.7 (5.0, 18.0); p = 0.210)]. In logistic regression analysis, after adjusting for potential confounders, such as vomiting, abnormal mental status, and systolic hypotension (
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0073728