Background: Severe pneumonia remains a leading cause of childhood mortality worldwide, particularly in low- and middle-income countries. Identifying risk factors associated with death is essential to guide early interventions and improve survival.
Aim of the study: To determine clinical, demographic, and laboratory predictors of mortality in children aged 2 months to 5 years admitted with severe pneumonia.
Methods: This retrospective observational study was conducted at the Department of Pediatrics, Kustia General Hospital, Kustia, Bangladesh. Medical records of 140 children admitted with severe pneumonia were reviewed. Data on sociodemographics, clinical parameters, laboratory findings, treatment interventions, and outcomes were extracted using a structured form. Statistical analysis was performed using SPSS v26, employing descriptive statistics, Chi-square/Fisher’s exact test, Mann-Whitney U test, and multivariable logistic regression to identify independent predictors of mortality. Model fitness was assessed with the Hosmer-Lemeshow test.
Result: Overall mortality was 21.42%. Independent predictors of death included hypoxia at admission, hypotension, leukocytosis, delayed care beyond 72 hours, and early mechanical ventilation. Protective factors included exclusive breastfeeding, absence of household smoking, and no prior COVID-19 exposure. Socioeconomic status significantly influenced outcomes. Multivariable logistic regression demonstrated that hypoxia (aOR=4.25; 95%CI: 2.10-8.59) and early mechanical ventilation (aOR=5.87; 95%CI: 3.12-11.03) were the strongest independent predictors of mortality.
Conclusion: Mortality in children with severe pneumonia is strongly influenced by both clinical severity and modifiable environmental factors. Early recognition, timely intervention, and addressing preventable risk factors, such as delayed care and household exposures, are essential to reduce deaths. These findings highlight the need for targeted strategies in resource-limited pediatric settings.
International Journal of Paediatrics and Geriatrics
