Factors associated with mortality in children with severe pneumonia and acute respiratory failure in Pattani province: A retrospective case-control study
Keywords:
Pneumonia, Acute respiratory failure, Respiratory acidosis, Pneumonia, Acute respiratory failure, Respiratory acidosis, Hypercapnia, Congenital heart defect, Respiratory distress syndrome, Congenital heart disease, Pediatric intensive careAbstract
Background: Pneumonia is the leading global cause of death among children under five years old. In Pattani province, Thailand, pneumonia is also a leading cause of pediatric respiratory failure and carries the highest mortality rate within the region. Identifying risk factors for mortality is crucial for improving prevention, diagnosis, and treatment.
Objective: This study aimed to determine factors associated with mortality in children with severe pneumonia and acute respiratory failure in Pattani province.
Methods: We conducted a retrospective case–control study of children aged 1 month to 15 years who were admitted with severe pneumonia and acute respiratory failure from January 1, 2020 to December 31, 2023. We classified patients into two groups: those who died (n = 10) and those who survived (n = 60). Data were extracted from medical records and referral forms. We used an exact probability tests and generalized linear models to estimate the risk difference [RD] with 95% confidence interval [CI].
Results: Among the 70 children hospitalized with severe pneumonia and acute respiratory failure, 10 (14.3%) died. In multivariable analysis, the following risk factors were significantly associated with mortality: congenital heart disease (RD 0.39, 95% CI 0.054–0.734), respiratory acidosis (venous blood gas pH < 7.3) on admission (RD 0.24, 95% CI 0.044–0.439), and hypercapnia (pCO2 > 50 mmHg) on admission (RD 0.44, 95% CI 0.071–0.810).
Conclusion: Congenital heart disease, respiratory acidosis, and hypercapnia at presentation were independent risk factors for mortality among children with severe pneumonia and acute respiratory failure. Close monitoring and early intervention for these high-risk patients are essential to reduce mortality.
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