Prognostic factors of hospitalized children with pneumonia

Background: Pneumonia is still the leading cause of mortalityin under-five children. Some clinical characteristics have been tocontribute the death of pneumonia in children. Objective: To identify the prognostic factors of pneumonia in underfive children Methods: This retrospective study is conducted in Ciptomangunkusumo Hospital Jakarta to recruit under-five childrenwith pneumonia who were hospitalized during the period oftwo years (2008–2010). Patients were treated with first-lineantibiotic ampicillin and chloramphenicol as the hospital guideline. Prognostic factors evaluated in this study were gender, age undertwelve-months old, comorbidities, nutritional status, severity ofpneumonia, degree of fever and leucocyte counts. Primary outcomeis failure clinical response after 3 days of initial treatment. Results: There were 108 patients (64.4% were boys) included inthis study. The mean age of patients was 13.7 months. From thisnumber of patients, 87 (83.7%) patients were classified as verysevere pneumonia. Eighty patients (76.9%) showed good clinicalresponse of initial treatment after 3 days. The failure group consistedof persistent clinical features, worsening condition and death cases.After multivariate analysis was performed, the prognostic factorsthat were statistically significant to the outcome were Downsyndrome as comorbid, very severe pneumonia and fever morethan 39.5°C with the OR [9.5 (95% CI 2.55–35.4; 8.8 (95% CI 2.76–28.16) and 5.1 (95% CI 1.06–24.82) respectively. Conclusion: The majority of pneumonia cases showed goodclinical response of initial treatment with first-line antibiotic.The prognostic factors which have correlation with failure oftreatment are Down Syndrome, very severe pneumonia andhigh fever >39.5°C.