Predictors of mortality in children with pneumonia in a semi-urban tertiary care hospital in south india

Prabakar, S., Ramanathan, R and Hari Vasudevan, S

Objective: To identify the risk factors for mortality associated with pneumonia
Design: Descriptive Study
Setting: Semi-Urban tertiary care hospital
Methods: 100 cases of children aged between 1month to 12 years who were admitted to paediatric wards with tachypnoea as per WHO criteria and chest indrawing in Rajah Muthiah Medical College, Chidambaram were included in the study. Detailed history, physical examination were recorded in a proforma. Investigations included CBC, Chest X ray. Significant predictors of mortality were determined by comparing not survived with survived subjects in statistical analysis (p value< 0.05).
Results: Respiratory distress (100%), cough (100%) and fever (99%) were the most common symptoms. Refusal of feeds was present in 24% cases. Tachypnoea (100%), chest retractions (100%) and crepitations (82%) were the most common signs. The case fatality rate was 6%. Majority of deaths occurred within 24 hours of presentation to hospital. Significant predictors of mortality were associated illness (meningitis, CCF), PEM (Grades 3&4), bottle feeding.
Conclusion: ARI, especially pneumonia is one of the major causes of morbidity and mortality in children. Symptoms and signs like cough, fever, tachypnea, chest indrawing, crepitations mentioned in the WHO ARI control programme were very sensitive and can be applied to hospitalized children. Bottle feeding, PEM grade 3 and 4, and associated illness (meningitis, CCF) were the important risk factors for mortality.


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