학술논문
In-hospital mortality risk stratification in children aged under 5 years with pneumonia with or without pulse oximetry: A secondary analysis of the Pneumonia REsearch Partnership to Assess WHO REcommendations (PREPARE) dataset.
Document Type
Academic Journal
Author
Hooli S; Division of Pediatric Emergency Medicine, Texas Children's Hospital/Baylor College of Medicine, Houston, United States of America.; King C; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden and Institute for Global Health, University College London, London, United Kingdom.; McCollum ED; Global Program in Respiratory Sciences, Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, United States of America and Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America.; Colbourn T; Institute for Global Health, University College London, London, United Kingdom.; Lufesi N; Ministry of Health, Lilongwe, Malawi.; Mwansambo C; Ministry of Health, Lilongwe, Malawi.; Gregory CJ; Division of Vector-Borne Diseases, US Centers for Disease Control and Prevention, Fort Collins, United States of America.; Thamthitiwat S; Division of Global Health Protection, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.; Cutland C; African Leadership in Vaccinology Expertise (Alive), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.; Madhi SA; South African Medical Research Council: Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg, South Africa.; Nunes MC; South African Medical Research Council: Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg, South Africa.; Gessner BD; Pfizer Vaccines, Collegeville, United States of America.; Hazir T; The Children's Hospital, (Retired), Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan (deceased).; Mathew JL; Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.; Addo-Yobo E; Kwame Nkrumah University of Science & Technology/Komfo Anokye Teaching Hospital, Kumasi, Ghana.; Chisaka N; World Bank, Washington DC, United States of America.; Hassan M; The Children's Hospital, Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan (deceased).; Hibberd PL; Department of Global Health, Boston University School of Public Health, Boston, United States of America.; Jeena P; University of KwaZulu-Natal, Durban, South Africa.; Lozano JM; Florida International University, Miami, United States of America.; MacLeod WB; Department of Global Health, Boston University School of Public Health, Boston, United States of America.; Patel A; Lata Medical Research Foundation, Nagpur and Datta Meghe Institute of Medical Sciences, Sawangi, India.; Thea DM; Department of Global Health, Boston University School of Public Health, Boston, United States of America.; Nguyen NTV; Children Hospital No 1, Ho Chi Minh City, Vietnam.; Zaman SM; Liverpool School of Tropical Medicine, Liverpool, United Kingdom.; Ruvinsky RO; Dirección de Control de Enfermedades Inmunoprevenibles, Ministerio de Salud de la Nación, Buenos Aires, Argentina.; Lucero M; Research Institute for Tropical Medicine, Manila, Philippines.; Kartasasmita CB; Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.; Turner C; Shoklo Malaria Research Unit, Mae Sot, Thailand.; Asghar R; Rawalpindi Medical College, Rawalpindi, Pakistan.; Banajeh S; Sana'a University, Sana'a, Yemen.; Iqbal I; Combined Military Hospital Institute of Medical Sciences, Multan, Pakistan.; Maulen-Radovan I; Instituto Nacional de Pediatria Division de Investigacion Insurgentes, Mexico City, Mexico.; Mino-Leon G; Children's Hospital Dr Francisco de Ycaza Bustamante, Head of Department, Infectious diseases, Guayaquil, Ecuador.; Saha SK; Child Health Research Foundation and Dhaka Shishu Hospital, Dhaka, Bangladesh.; Santosham M; International Vaccine Access Center (IVAC), Department of International Health, Johns Hopkins University, Baltimore, United States of America.; Singhi S; Medanta, The Medicity, Gurgaon, India.; Awasthi S; King George's Medical University, Department of Pediatrics, Lucknow, India.; Bavdekar A; KEM Hospital Pune, Department of Pediatrics, Pune, India.; Chou M; University of Health Sciences, Rodolph Mérieux Laboratory & Ministry of Environment, Phom Phen, Cambodia.; Nymadawa P; Mongolian Academy of Sciences, Academy of Medical Sciences, Ulaanbaatar, Mongolia.; Pape JW; GHESKIO, Centre GHESKIO, Port au Prince, Haiti.; Paranhos-Baccala G; Fondation Merieux, Lyon, France.; Picot VS; Fondation Merieux, Lyon, France.; Rakoto-Andrianarivelo M; Centre d'Infectiologie Charles Mérieux, Antananarivo, Madagascar.; Rouzier V; GHESKIO, Department of Pediatrics, Port au Prince, Haiti.; Russomando G; Universidad Nacional de Asuncion, Departamento de Biología Molecular y Genética, Instituto de Investigaciones en Ciencias de la Salud, Asuncion, Paraguay.; Sylla M; Gabriel Touré Hospital, Department of Pediatrics, Bamako, Mali.; Vanhems P; Unité d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France and Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale U1111, CNRS Unité Mixte de Recherche 5308, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, Lyon, France.; Wang J; Chinese Academy of Medical Sciences & Peking Union, Medical College Institute of Pathogen Biology, MOH Key Laboratory of Systems Biology of Pathogens and Dr Christophe Mérieux Laboratory, Beijing, China.; Basnet S; Center for Intervention Science in Maternal and Child Health, University of Bergen, Norway and Department of Pediatrics, Tribhuvan University Institute of Medicine, Nepal.; Strand TA; Research Department, Innlandet Hospital Trust, Lillehammer, Norway.; Neuman MI; Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, United States of America.; Arroyo LM; PNUD/National University, Montevideo, Uruguay.; Echavarria M; Clinical Virology Unit, Centro de Educación Médica e Investigaciones Clínicas, Mar del Plata, Argentina.; Bhatnagar S; Translational Health Science and Technology Institute, Faridabad, India.; Wadhwa N; Translational Health Science and Technology Institute, Faridabad, India.; Lodha R; All India Institute of Medical Sciences, New Delhi, India.; Aneja S; School of Medical Sciences & Research, Sharda University, Greater Noida, India.; Gentile A; Department of Epidemiology, 'R. Gutiérrez' Children's Hospital, Buenos Aires, Argentina.; Chadha M; Former Scientist G, ICMR National Institute of Virology, Pune, India.; Hirve S; KEM Hospital Research Center, Pune, India.; O'Grady KF; Australian Centre for Health Services Innovation, Queensland University of Technology, Kelvin Grove, Australia.; Clara AW; Centers for Disease Control, Central American Region, Guatemala City, Guatemala.; Rees CA; Division of Pediatric Emergency Medicine, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, United States of America.; Campbell H; Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland.; Nair H; Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland.; Falconer J; Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland.; Williams LJ; Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland.; Horne M; Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, Scotland.; Qazi SA; Department of Maternal, Newborn, Child, and Adolescent Health (Retired), World Health Organization, Geneva, Switzerland.; Nisar YB; Department of Maternal, Newborn, Child, and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland. Electronic address: nisary@who.int.
Source
Publisher: Elsevier Country of Publication: Canada NLM ID: 9610933 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-3511 (Electronic) Linking ISSN: 12019712 NLM ISO Abbreviation: Int J Infect Dis Subsets: MEDLINE
Subject
Language
English
Abstract
Objectives: We determined the pulse oximetry benefit in pediatric pneumonia mortality risk stratification and chest-indrawing pneumonia in-hospital mortality risk factors.
Methods: We report the characteristics and in-hospital pneumonia-related mortality of children aged 2-59 months who were included in the Pneumonia Research Partnership to Assess WHO Recommendations dataset. We developed multivariable logistic regression models of chest-indrawing pneumonia to identify mortality risk factors.
Results: Among 285,839 children, 164,244 (57.5%) from hospital-based studies were included. Pneumonia case fatality risk (CFR) without pulse oximetry measurement was higher than with measurement (5.8%, 95% confidence interval [CI] 5.6-5.9% vs 2.1%, 95% CI 1.9-2.4%). One in five children with chest-indrawing pneumonia was hypoxemic (19.7%, 95% CI 19.0-20.4%), and the hypoxemic CFR was 10.3% (95% CI 9.1-11.5%). Other mortality risk factors were younger age (either 2-5 months [adjusted odds ratio (aOR) 9.94, 95% CI 6.67-14.84] or 6-11 months [aOR 2.67, 95% CI 1.71-4.16]), moderate malnutrition (aOR 2.41, 95% CI 1.87-3.09), and female sex (aOR 1.82, 95% CI 1.43-2.32).
Conclusion: Children with a pulse oximetry measurement had a lower CFR. Many children hospitalized with chest-indrawing pneumonia were hypoxemic and one in 10 died. Young age and moderate malnutrition were risk factors for in-hospital chest-indrawing pneumonia-related mortality. Pulse oximetry should be integrated in pneumonia hospital care for children under 5 years.
(Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Methods: We report the characteristics and in-hospital pneumonia-related mortality of children aged 2-59 months who were included in the Pneumonia Research Partnership to Assess WHO Recommendations dataset. We developed multivariable logistic regression models of chest-indrawing pneumonia to identify mortality risk factors.
Results: Among 285,839 children, 164,244 (57.5%) from hospital-based studies were included. Pneumonia case fatality risk (CFR) without pulse oximetry measurement was higher than with measurement (5.8%, 95% confidence interval [CI] 5.6-5.9% vs 2.1%, 95% CI 1.9-2.4%). One in five children with chest-indrawing pneumonia was hypoxemic (19.7%, 95% CI 19.0-20.4%), and the hypoxemic CFR was 10.3% (95% CI 9.1-11.5%). Other mortality risk factors were younger age (either 2-5 months [adjusted odds ratio (aOR) 9.94, 95% CI 6.67-14.84] or 6-11 months [aOR 2.67, 95% CI 1.71-4.16]), moderate malnutrition (aOR 2.41, 95% CI 1.87-3.09), and female sex (aOR 1.82, 95% CI 1.43-2.32).
Conclusion: Children with a pulse oximetry measurement had a lower CFR. Many children hospitalized with chest-indrawing pneumonia were hypoxemic and one in 10 died. Young age and moderate malnutrition were risk factors for in-hospital chest-indrawing pneumonia-related mortality. Pulse oximetry should be integrated in pneumonia hospital care for children under 5 years.
(Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)