A retrospective analysis of clinical features and risk factors of death in children with severe pneumonia treated with invasive mechanical ventilation / 中国小儿急救医学

ABSTRACT

Objective To discuss the clinical features and risk factors of death in children with severe pneumonia treated with invasive mechanical ventilation.Methods Through a retrospective analysis of children with severe pneumonia treated with invasive mechanical ventilation,who were hospitalized in PICU of Tianjin Children′s Hospital from Jan 2011 to Dec 2014,we analyzed the distribution of age,etiologic characteristics,mechanical ventilation,complications and background diseases.The single factor analysis and multiple factors Logistic regression analysis were performed to evaluate the risk factors of death.Results A total of 214 pediatric patients were included,134 were male,and 80 were female.The case fatality rate was 6.17%,the relevance ratio of pathogenic microorganism was 16.36%.The median age of death group was older than that of the survival group(4 mouths vs 2 mouths,P=0.039).The pediatric patients who were more than 1 year old in death group were more than the survival group(21.43% vs 15.8%,P<0.001).The common complications included dencephalopathy(11.68%) and electrolyte imbalance(8.41%).Anemia,cardiopathy and alloplasia of respiratory system were the top background diseases.The results of Logistic multivariate regression analysis showed that there were significant differences in the age above 1 year old(OR1.019,95%CI1.003-1.030,P=0.019),secondary acute respiratory distress syndrome(OR7.254,95%CI1.581-33.277,P=0.011) and accompanying cardiopathy(OR0.47,95%CI0.273-0.81,P=0.007).Conclusion The risk factors of death in children with severe pneumonia treated with invasive mechanical ventilation are the followingthe age above 1 year old,secondary acute respiratory distress syndrome or accompanying cardiopathy.