TY - JOUR
T1 - Risk factors for a poor outcome among children admitted with clinically severe pneumonia to a university hospital in Rabat, Morocco
AU - Jroundi, Imane
AU - Mahraoui, Chafiq
AU - Benmessaoud, Rachid
AU - Moraleda, Cinta
AU - Tligui, Houssain
AU - Seffar, Myriam
AU - Kettani, Salma Ech Cherif El
AU - Benjelloun, Badr Sououd
AU - Chaacho, Saad
AU - Muñoz-Almagro, Carmen
AU - Ruiz, Joaquim
AU - Alonso, Pedro L.
AU - Bassat, Quique
N1 - Publisher Copyright:
© 2014 The Authors.
PY - 2014/11/1
Y1 - 2014/11/1
N2 - Objectives: Data on prognostic factors among children with severe pneumonia are scarce in middle-income countries. We investigated prognostic factors for an adverse outcome among children admitted to the HÔpital d'Enfants de Rabat, Morocco with World Health Organization-defined clinically severe pneumonia (CSP). Methods: Children aged 2-59 months admitted to the hospital and fulfilling the CSP definition were recruited into this 13-month prospective study. A poor prognosis was defined as death, a need for intensive care, or a Respiratory Index of Severity in Children (RISC) score ≥3. Multivariate logistic regression was performed to ascertain independent predictive factors for a poor prognosis. Results: Of the 689 children included in this analysis, 55 (8.0%) required intensive care and 28 died (4.0%). Five hundred and two (72.8%) children were classified as having a good prognosis and 187 (27.2%) as having a poor prognosis. A history of prematurity (odds ratio (OR) 2.50, 95% confidence interval (CI) 1.24-5.04), of fever (OR 2.25, 95% CI 1.32-3.83), living in a house with smokers (OR 1.79, 95% CI 1.18-2.72), impaired consciousness (OR 10.96, 95% CI 2.88-41.73), cyanosis (OR 2.09, 95% CI 1.05-4.15), pallor (OR 2.27, 95% CI 1.34-3.84), having rhonchi on auscultation (OR 2.45, 95% CI 1.58-3.79), and human metapneumovirus infection (OR 2.13, 95% CI 1.13-4.02) were all independent risk factors for an adverse outcome, whereas a history of asthma (OR 0.46, 95% CI 0.25-0.84) was the only independent risk factor for a positive outcome. Conclusions: The early identification of factors associated with a poor prognosis could improve management strategies and the likelihood of survival of Moroccan children with severe pneumonia.
AB - Objectives: Data on prognostic factors among children with severe pneumonia are scarce in middle-income countries. We investigated prognostic factors for an adverse outcome among children admitted to the HÔpital d'Enfants de Rabat, Morocco with World Health Organization-defined clinically severe pneumonia (CSP). Methods: Children aged 2-59 months admitted to the hospital and fulfilling the CSP definition were recruited into this 13-month prospective study. A poor prognosis was defined as death, a need for intensive care, or a Respiratory Index of Severity in Children (RISC) score ≥3. Multivariate logistic regression was performed to ascertain independent predictive factors for a poor prognosis. Results: Of the 689 children included in this analysis, 55 (8.0%) required intensive care and 28 died (4.0%). Five hundred and two (72.8%) children were classified as having a good prognosis and 187 (27.2%) as having a poor prognosis. A history of prematurity (odds ratio (OR) 2.50, 95% confidence interval (CI) 1.24-5.04), of fever (OR 2.25, 95% CI 1.32-3.83), living in a house with smokers (OR 1.79, 95% CI 1.18-2.72), impaired consciousness (OR 10.96, 95% CI 2.88-41.73), cyanosis (OR 2.09, 95% CI 1.05-4.15), pallor (OR 2.27, 95% CI 1.34-3.84), having rhonchi on auscultation (OR 2.45, 95% CI 1.58-3.79), and human metapneumovirus infection (OR 2.13, 95% CI 1.13-4.02) were all independent risk factors for an adverse outcome, whereas a history of asthma (OR 0.46, 95% CI 0.25-0.84) was the only independent risk factor for a positive outcome. Conclusions: The early identification of factors associated with a poor prognosis could improve management strategies and the likelihood of survival of Moroccan children with severe pneumonia.
KW - Acute respiratory infections
KW - Morocco
KW - Paediatrics
KW - Pneumonia
KW - Prognosis
KW - Risk factors
UR - http://www.scopus.com/inward/record.url?scp=84949127436&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2014.07.027
DO - 10.1016/j.ijid.2014.07.027
M3 - Artículo
C2 - 25305555
AN - SCOPUS:84949127436
SN - 1201-9712
VL - 28
SP - e164-e170
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -