Hospitalization for respiratory disease among infants and young children at Cairo uuniversity teaching hospitals

ABSTRACT

Pulmonary diseases constitute a major cause for hospitalization. The aim of this work is to Assess the severe respiratory disease as a cause of admission to Cairo University Children's Hospital. The proportion of hospital bed occupancy due to respiratory disease and duration of hospitalization will be assessed in view of total hospital bed occupancy and compared to other medical conditions. Risk factors for severe respiratory disease leading to hospitalization in these patients will also be evaluated, the objectives are to Decrease the use of unnecessary diagnostic studies. This study was carried out on 393 patients who suffer from chest diseases and hospitalized in Cairo University Children's Hospitals over a period of three months, from February to April 2007. Patient's data were collected to show the epidemiological profile and risk factors of chest diseases. Regarding perinatal conditions 41 cases [10.4%] suffered from respiratory distress [RD], 16 cases [4.1%] premature rupture of membrane [PROM]. and 16 cases [4.1%] neonatal sepsis. Regarding immunization59 cases [15%] were incomplete for age. 103 cases [26.2%] were artificially fed. 154 cases [39.2%] were suffering from malnutrition. 130 cases [33.1%] had anemia. 271 cases [69%] from urban areas and 122 cases [31%] from rural areas. Natural gas was used in houses of 320 cases [81.4%], kerosene in 39 cases [9.9%] and wood in 34 cases [8.7%]. Passive smoking was present in 217 cases [55.2%]. Regarding number of siblings in home 248 cases [63.1%] less than two and 145 cases[36.9%] more than two. Regarding duration of hospitalization 244 cases [62.1%] stayed for less than I week, 100 cases [25.4%] between 1-2 weeks and 49 cases [12.5%] more than 2 weeks. Regarding frequency of hospitalization because of chest diseases 225 cases [57.3%] hospitalized for the first time, 96 cases [24.4%] for the second time,43 cases [10.4%] for the third time and 29 cases [7.4%] in ore than three times. The 393 cases were diagnosed as follows 315 cases [80.2%] pneumonia, 20 cases [5.1%] acute bronchiolitis, 19 cases [4.8%] foreign body aspiration, 11 cases [2.8%] pleural effusion, 7 cases [1.8%]bronchial asthma, 6 cases [1.5%] asthmatic bronchitis, 5 cases [1.2%] collapse, 4 cases [1%]. Hydropneumothorax, I case [0.3%] lung abcess, 1 case [0.3%] empyema, 1 case[0.3%] lung fibrosis, 1 case [0.3%] lung cyst, 1 case [0.3%] acute laryngotracheitis and I case [0.3%] acute bronchitis. Regarding underlying medical condition 49 cases [12.5%] had heart disease,15 cases [3.8%] neurological diseases [6 Down syndrome, 4 cerebral palsy, 2 convulsions,2 hydrocephalus and I Werdnig-Hoffman], 9 cases [2.3%] rickets and 5 cases [1.2%] others [3 gastroentritis, 1 pancytopenia and 1 nephrotic syndrome]. Hospitalization due to respiratory diseases constituted 23.9% from the total number hospitalized over this period. Identification of risk factors for severe respiratory disease is important in planning preventive strategies for the patients and community