<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1996-3696</journal-id>
<journal-title><![CDATA[Revista del Instituto de Medicina Tropical]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Inst. Med. Trop.]]></abbrev-journal-title>
<issn>1996-3696</issn>
<publisher>
<publisher-name><![CDATA[Instituto de Medicina Tropical]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1996-36962017000100010</article-id>
<article-id pub-id-type="doi">10.18004/imt/201712110-13</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Factores pronósticos de mortalidad en la neumonía adquirida de la comunidad en niños que requieren hospitalización]]></article-title>
<article-title xml:lang="en"><![CDATA[Prognostic factors of mortality in community-acquired pneumonia in children requiring hospitalization]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Peralta]]></surname>
<given-names><![CDATA[Katia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Araya]]></surname>
<given-names><![CDATA[Soraya]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sanabria]]></surname>
<given-names><![CDATA[Gabriela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Acuña]]></surname>
<given-names><![CDATA[Julia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lovera]]></surname>
<given-names><![CDATA[Dolores]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arbo]]></surname>
<given-names><![CDATA[Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto de Medicina Tropical Servicio de Pediatría ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto de Medicina Tropical Dirección de Docencia e Investigación ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad Nacional de Asunción Facultad de Ciencias Médicas ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>07</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>07</month>
<year>2017</year>
</pub-date>
<volume>12</volume>
<numero>1</numero>
<fpage>10</fpage>
<lpage>13</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S1996-36962017000100010&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S1996-36962017000100010&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S1996-36962017000100010&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[ Objetivo: Identificar los factores pronósticos de mortalidad en NAC en niños que requieren hospitalización.  Método: Estudio observacional, que incluyó a pacientes (pts) &lt;16 años que se hospitalizaron entre 2004-2008 por NAC, distribuyéndose en dos grupos según que hayan fallecido o sobrevivido durante la hospitalización. Se compararon variables demográficas, clínicas, laboratoriales, y evolutivas. La comorbilidad se definió en 3 categorías: I (sobrepeso, DCP I), II (cardiopatía congénita, Sindrome de Down) y III (VIH, cáncer hematológico, desnutrición grave). Se realizó análisis univariado y multivariado.  Resultados: Se hospitalizaron 341 pts con NAC, (edad media 33,6+34,8 meses), de los cuales 37 (11%) fallecieron. La edad &lt;6 meses (RR 0.12, IC 0.03-0.47, p=0.006), la presencia de comorbilidad II y III (RR 0.25, IC 0,14-0,45, p=0.00003), hipotensión (RR 0.05, IC 0.03-0.11, p=0.00001), convulsiones (RR 0.20, IC 0.10-0.39, p&lt;0.05) o Glasgow&lt;12 (RR 0.02, IC 0.01-0.05, p=0.00001) al ingreso se correlacionaron con mayor mortalidad. Laboratorialmente, la presencia de GB &lt;4000 (RR 0.21, IC 0.07-0.07, p=0.02), pH&lt;7.2, HCO3 &lt;15 (RR 0.02, IC 0.01-0.06, p=0.00001), saturación de O2 &lt;90% (RR 0.2, IC 0.11-0.36, p=0.0007), hiponatremia (RR 0.1, IC 0.04-0.23, p&lt;0.05), y compromiso multilobar fueron significativamente más frecuentes en los que fallecieron (RR 0.06, IC 0.02-0.17, p&lt;0.005). Durante la evolución clínica, el riesgo de morir se correlacionó con la necesidad de ARM y presencia de insuficiencia renal. (RR 0.04, IC 0.02-0.07, p=0.0001) Conclusiones. La mortalidad en NAC que se hospitaliza es significativa. Se han identificado condiciones predisponentes, variables demográficas, clínicas, de gabinete y evolutivas que son altamente predictivas de mortalidad.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Aim:  To identify the prognostic factors of mortality in CAP in children requiring hospitalization.  Method:  An observational study, which included patients (pts) &lt;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 &lt;0.05) or Glasgow &lt;12 (RR 0.02, IC 0.01-0.05, p = 0.00001) at admission were correlated with higher mortality. The presence of GB &lt;4000 (RR 0.21, IC 0.07-0.07, p = 0.02), pH &lt;7.2, HCO3 &lt;15 (RR 0.02, IC 0.01-0.06, p = 0.00001), O2 saturation &lt;90% (RR 0.16, p &lt;0.05), and multilobar involvement were significantly more frequent in those who died (RR 0.06, CI 0.02-0.17, p &lt;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]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Compromiso multilobar]]></kwd>
<kwd lng="es"><![CDATA[pediatría]]></kwd>
<kwd lng="en"><![CDATA[multilobar involvement]]></kwd>
<kwd lng="en"><![CDATA[pediatric]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Andreo]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Domínguez]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Ruiz]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Blanco]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Arellano]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Prat]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Impact of rapid urine antigen tests to determine the etiology of community-acquired pneumoniae in adults.]]></article-title>
<source><![CDATA[Respir Med.]]></source>
<year>2006</year>
<volume>100</volume>
<page-range>884-9</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chiou]]></surname>
<given-names><![CDATA[CCC]]></given-names>
</name>
<name>
<surname><![CDATA[Yu]]></surname>
<given-names><![CDATA[VL.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Severe pneumococcal pneumonia: new strategies for management.]]></article-title>
<source><![CDATA[Curr Opin Crit Care]]></source>
<year>2006</year>
<volume>12</volume>
<page-range>470-6</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mason]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Nelson]]></surname>
<given-names><![CDATA[S.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pulmonary host defenses and factors predisposing to lung infection.]]></article-title>
<source><![CDATA[Clin Chest Med]]></source>
<year>2005</year>
<volume>26</volume>
<page-range>11</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Welte]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Torres]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Nathwani]]></surname>
<given-names><![CDATA[D.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical and economic burden of community-acquired pneumonia among adults in Europe]]></article-title>
<source><![CDATA[Review Thorax]]></source>
<year>2012</year>
<volume>67</volume>
<page-range>71-9</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Reynolds]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Banerjee]]></surname>
<given-names><![CDATA[AK.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Imaging pneumonia in immunocompetent and immunocompromised individuals]]></article-title>
<source><![CDATA[Curr Opin Pulm Med]]></source>
<year>2012</year>
<volume>18</volume>
<page-range>194-201</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Grijalva]]></surname>
<given-names><![CDATA[CG]]></given-names>
</name>
<name>
<surname><![CDATA[Nuorti]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
<name>
<surname><![CDATA[Zhu]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Griffin]]></surname>
<given-names><![CDATA[MR.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Increasing incidence of empyema complicating childhood communityacquired pneumonia in the United States]]></article-title>
<source><![CDATA[Clin Infect Dis]]></source>
<year>2010</year>
<volume>50</volume>
<page-range>805</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gray]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
<name>
<surname><![CDATA[Zar]]></surname>
<given-names><![CDATA[HJ.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Community-acquired pneumonia in HIV infected children: a global perspective.]]></article-title>
<source><![CDATA[Curr Opin Pulm Med]]></source>
<year>2010</year>
<volume>16</volume>
<page-range>208</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martinón-Torres]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Bernaola Iturbe]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Giménez Sánchez]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Baca Cots]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[De Juan Martín]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Díez Domingo]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[¿Por qué hay más empiemas pediátricos en Espana?]]></article-title>
<source><![CDATA[An Pediatr (Barc)]]></source>
<year>2008</year>
<volume>68</volume>
<page-range>158</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[JY]]></given-names>
</name>
<name>
<surname><![CDATA[Hwang]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
<name>
<surname><![CDATA[Shim]]></surname>
<given-names><![CDATA[JW]]></given-names>
</name>
<name>
<surname><![CDATA[Jung]]></surname>
<given-names><![CDATA[HL]]></given-names>
</name>
<name>
<surname><![CDATA[Park]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
<name>
<surname><![CDATA[Woo]]></surname>
<given-names><![CDATA[HY]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical significance of serum procalcitonin in patients with community-acquired lobar pneumonia]]></article-title>
<source><![CDATA[Korean J Lab Med]]></source>
<year>2010</year>
<volume>30</volume>
<page-range>406</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Johansson]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Kalin]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Tiveljung-Lindell]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Giske]]></surname>
<given-names><![CDATA[CG]]></given-names>
</name>
<name>
<surname><![CDATA[Hedlund]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Etiology of community-acquired pneumonia: increased microbiological yield with new diagnostic methods]]></article-title>
<source><![CDATA[Clin Infect Dis]]></source>
<year>2010</year>
<volume>50</volume>
<page-range>202</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
