Risk factors for death in children with severe adenovirus pneumonia in southwest Chongqing
10.3760/cma.j.cn101070-20201029-01684
- VernacularTitle:重庆西南地区儿童重症腺病毒肺炎死亡的危险因素分析
- Author:
Wenjing LI
1
;
Dandan PI
;
Mi YAN
;
Chengjun LIU
Author Information
1. 重庆医科大学附属儿童医院重症医学科，国家儿童健康与疾病临床医学研究中心，儿童发育疾病研究教育部重点实验室，儿科学重庆市重点实验室，重庆 400014
- Keywords:
Adenovirus;
Severe pneumonia;
Child;
Risk factor
- From:
Chinese Journal of Applied Clinical Pediatrics
2022;37(4):265-268
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors for death in children with severe adenovirus pneumonia (SAP) in pediatric intensive care unit (PICU), and to provide reference basis for clinical reasonable treatment and reducing the adverse outcome.Methods:The clinical data of 68 children with SAP hospitalized in PICU, Children′s Hospital of Chongqing Medical University from August 2018 to September 2019 were retrospectively analyzed.They were divided into the death group and the survival group according to their condition.The age, basic diseases, complications and laboratory examination results of children were collected for univariate analysis, and multivariate Logistic regression analysis was performed for those with significant univariate analysis. Results:Among the 68 children with SAP, 50 were males and 18 were females, and 46 cases (67.6%) aged between 6 months and 2 years.Fifty-five cases(80.9%) of SAP occurred in spring and summer.There were 61 cases (89.7%) with the spike over 39 ℃ and 21 cases (30.9%) had fever for over 2 weeks; 42 cases (61.8%) were infected with mixed other pathogens.Intrapulmonary and extrapulmonary complications at varying severity were observed.There were 23 cases (33.8%) deaths.Univariable Logistic regression analysis showed that the rates of congenital heart disease(13 cases vs. 9 cases), alanine transaminase >100 U/L(12 cases vs. 8 cases), acute respiratory distress syndrome (ARDS)(13 cases vs. 9 cases) and severe extrapulmonary complications (19 cases vs. 14 cases) were significantly higher in the death group than those in the survival group (all P<0.05). Multivariate Logistic regression analysis showed that congenital heart disease, ARDS and severe extrapulmonary complications were independent risk factors for death in children with SAP (all P<0.05). Conclusions:Children with SAP in PICU are mostly 6 months to 2 years old.SAP mainly occurs in spring and summer, which is featured by the high spike of fever, long duration of fever, easy to be infected with other pathogens, high incidences of systemic complications, and high mortality.The combination of congenital heart disease, ARDS and severe extrapulmonary complications increases the risk of death in children with SAP in PICU.
