Aim:

To identify the prognostic factors of mortality in CAP in children requiring hospitalization.

Method:

An observational study, which included patients (pts) <16 years who were hospitalized between 2004-2008 for CAP, and distributed in two groups according to whether they died or survived during hospitalization. Demographic, clinical, laboratorial, and evolutionary variables were compared. Comorbidity was defined in 3 categories: I (overweight, DCP I), II (congenital heart disease, Down Sx) and III (HIV, hematologic cancer, severe malnutrition). Univariate and multivariate analyzes were performed.

Results:

341 pts were hospitalized with CAP, (mean age 33.6 ± 34.8 months), of which 37 (11%) died. The presence of comorbidity II and III (RR 0.25, CI 0.14-0.45, p = 0.00003), hypotension (RR 0.05, CI 0.03-0.11, p = 0.00001), seizures (RR 0.20, IC 0.10-0.39, p <0.05) or Glasgow <12 (RR 0.02, IC 0.01-0.05, p = 0.00001) at admission were correlated with higher mortality. The presence of GB <4000 (RR 0.21, IC 0.07-0.07, p = 0.02), pH <7.2, HCO3 <15 (RR 0.02, IC 0.01-0.06, p = 0.00001), O2 saturation <90% (RR 0.16, p <0.05), and multilobar involvement were significantly more frequent in those who died (RR 0.06, CI 0.02-0.17, p <0.05) 0.005). During the clinical course, the risk of dying was correlated with the need for MRA and presence of renal failure. (RR 0.04, IC 0.02-0.07, p = 0.0001)

Conclusions:

Mortality in hospitalized CAP is significant. Predisposing conditions, demographic, clinical, cabinet and evolutionary variables that are highly predictive of mortality have been identified

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