Predictive Factors of Pulmonary Complications in Pediatric Patients with Community-Acquired Pneumonia (CAP)

Abstract

Community-acquired pneumonia or CAP (Community-Acquired Pneumonia) in childhood is defined as an acute infection of the lung parenchyma in a child caused by a pathogen originating outside the hospital, i.e. in the community. This disease is one of the most important causes of illness in developed countries and one of the most important causes of death in developing countries. This study aims to evaluate the factors predicting the occurrence of pulmonary complications in children with community-acquired pneumonia. Materials and Methods: In this study, all children admitted to Zahra Mardani-Azar Children's Hospital in Tabriz due to community-acquired pneumonia between October 2022 and October 2023 were included in the study. Children were divided into two groups based on the clinical course of the disease, including 1- children with CAP with PPE/PE (Para-Pneumonic Effusion/Pleural Effusion), NP (Necrotizing Pneumonia), or lung abscess and 2- children with CAP without lung complications; Are. Finally, the patients of two groups in terms of demographic information [including age, gender, weight, height, and body mass index (BMI) (Body Mass Index)]; Medical records [including the history of antibiotic use, antipyretic treatment including acetaminophen and ibuprofen, and anti-inflammatory treatments]; Medicines used during treatment [such as anti-fever drugs, anti-inflammatories, and antibiotics, etc.]; clinical signs and symptoms [including fever, respiratory rate and cough]; Laboratory findings on admission and during hospital treatment [including CBC (Complete Blood Count), ESR (Erythrocyte Sedimentation Ratio), CRP (C-Reactive Protein), Bun (Blood Urea Nitrogen), Cr (Creatinine), VBG (Venous Blood Gases)]; the results of chest radiography and computed tomography (CT-Scan) (Computed Tomography Scan); and the clinical course of the disease [including the time of onset of clinical symptoms and the time of onset of fever until referral and hospitalization]; were compared. Results: Finally, 361 patients were evaluated, of which 104 (28.8%) were in the case group and 257 (71.2%) were in the control group. Risk factors for pulmonary complications in children with CAP include weight (OR=1.129), height (OR=1.112), BMI (OR=1.112), administration of oral and intravenous acetaminophen during hospitalization (OR=1.112, 1.209; respectively), tachypnea (OR=5.178), duration of fever (OR=1.290), ESR during hospitalization (OR= 1.312) and HRAD (OR=3.473) during hospitalization.