Predictors of mortality in subjects hospitalized with acute lower respiratory tract infections.
Indian Pediatr
;
1997 Mar; 34(3): 213-9
Article
in English
| IMSEAR
| ID: sea-12471
ABSTRACT
OBJECTIVE:
To identify the predictors of mortality due to acute lower respiratory tract infection (ALRI).DESIGN:
Prospective cohort study.SETTING:
Urban tertiary care teaching hospital.METHODS:
201 cases with ALRI between 2 weeks to 5 years of age were prospectively enrolled and followed up to determine outcome. Detailed history and clinical evaluation were recorded on a pretested proforma. Significant independent predictors of mortality were determined by comparison of dead subjects (n = 21) with surviving children (n = 180) in a multiple logistic analytic framework.RESULTS:
The case fatality rate (CFR) was 10.45%. Significant independent predictors of mortality were (OR, 95% CI) age less than 1 year (23.1, 2.7-197.5), inability to feed (6.2, 1.3-30.7), associated loose stools (5.1,1.2-27.3), weight for age Z score < -3 (3.9,1.01-9.7), short duration of fever (1.2,1.0-1.5) and bandemia (1.1,1.05-1.2). The WHO guidelines identified 91% of children diagnosed as ALRI by clinical and investigative criteria. The CFR was related to severity of WHO classification ("pneumonia"-0%, "severe pneumonia"-8.7% and "very severe pneumonia"-47.0%). However, 2 of the 18 subjects with a diagnosis of "no pneumonia" expired (CFR 11.1% and 10% of total mortality).CONCLUSION:
Even in settings of high case fatality, predictors of mortality can be identified in under five children suffering from ALRI. In this context, age below 1 year, inability to feed, presence of loose stools and severe malnutrition merit attention for interventional purposes.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Pneumonia
/
Respiratory Tract Infections
/
Socioeconomic Factors
/
Female
/
Humans
/
Male
/
Infant, Newborn
/
Confidence Intervals
/
Odds Ratio
/
Child, Preschool
Type of study:
Diagnostic study
/
Etiology study
/
Evaluation studies
/
Practice guideline
/
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
Country/Region as subject:
Asia
Language:
English
Journal:
Indian Pediatr
Year:
1997
Type:
Article
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