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Predictors of mortality in subjects hospitalized with acute lower respiratory tract infections.
Indian Pediatr. 1997 Mar; 34(3):213-9.IP

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.

Authors+Show Affiliations

Department of Pediatrics, Maulana Azad Medical College, New Delhi.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9282488

Citation

Sehgal, V, et al. "Predictors of Mortality in Subjects Hospitalized With Acute Lower Respiratory Tract Infections." Indian Pediatrics, vol. 34, no. 3, 1997, pp. 213-9.
Sehgal V, Sethi GR, Sachdev HP, et al. Predictors of mortality in subjects hospitalized with acute lower respiratory tract infections. Indian Pediatr. 1997;34(3):213-9.
Sehgal, V., Sethi, G. R., Sachdev, H. P., & Satyanarayana, L. (1997). Predictors of mortality in subjects hospitalized with acute lower respiratory tract infections. Indian Pediatrics, 34(3), 213-9.
Sehgal V, et al. Predictors of Mortality in Subjects Hospitalized With Acute Lower Respiratory Tract Infections. Indian Pediatr. 1997;34(3):213-9. PubMed PMID: 9282488.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of mortality in subjects hospitalized with acute lower respiratory tract infections. AU - Sehgal,V, AU - Sethi,G R, AU - Sachdev,H P, AU - Satyanarayana,L, PY - 1997/3/1/pubmed PY - 1997/3/1/medline PY - 1997/3/1/entrez KW - Age Factors KW - Asia KW - Biology KW - Child KW - Child Mortality--determinants KW - Child Survival KW - Correlation Studies KW - Demographic Factors KW - Developing Countries KW - Diseases KW - India KW - Infant Mortality--determinants KW - Infections KW - Length Of Life KW - Mortality KW - Population KW - Population Characteristics KW - Population Dynamics KW - Prospective Studies KW - Research Methodology KW - Research Report KW - Respiratory Infections KW - Risk Factors KW - Signs And Symptoms KW - Southern Asia KW - Statistical Studies KW - Studies KW - Survivorship KW - Youth SP - 213 EP - 9 JF - Indian pediatrics JO - Indian Pediatr VL - 34 IS - 3 N2 - 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. SN - 0019-6061 UR - https://www.unboundmedicine.com/medline/citation/9282488/Predictors_of_mortality_in_subjects_hospitalized_with_acute_lower_respiratory_tract_infections_ L2 - https://medlineplus.gov/pneumonia.html DB - PRIME DP - Unbound Medicine ER -