1.Risk factors in predicting mortality among children admitted for PCAP C and D at Philippine Children’s Medical Center.
Excelle Grace M. Canonizado ; Mary Therese M. Leopando
The Philippine Children’s Medical Center Journal 2021;17(1):1-11
OBJECTIVE:
The study aimed to identify risk factors associated with mortality among patients
admitted for PCAP C and D.
METHODOLOGY:
The study was a cross-sectional study involving children admitted for
PCAP C and D at PCMC from January 2017 to December 2019. Univariate and multivariate
analyses through binomial logistic regression were used to determine significant predictors of
mortality.
RESULTS:
A total of 472 patients were included in the study, of whom 77% had PCAP C and
23% had PCAP D. More than half in each patient group were infants; male; and of normal
nutritional status. Most common comorbidities in both groups were neurologic and
cardiovascular in nature. Leukocytosis, thrombocytosis, and anemia were the most common
hematologic findings. Overall mortality rate among patients was 5.08%. On univariate analysis,
being severely underweight (cOR 8.28 [95% CI 2.52–27.23]), with history of antibiotic use (cOR
3.01 [95% CI 1.18–7.62], neurologic comorbidities (cOR 4.04 [95% CI 1.42–11.43]), cardiac
comorbidities (cOR 5.33 [95% CI 1.31–21.75]), Down syndrome (cOR 22.11 [95% CI 2.44-
200.30]), and thrombocytopenia (cOR 22.11 [95% CI 2.44-200.30]) were associated with greater
odds of mortality among PCAP-D patients. On multivariate analysis, the odds of mortality were
5.02 (95% CI 1.05-23.96) for severely underweight patients, 4.51 (95% CI 1.13-17.95) in
patients with neurologic disease, and 73.62 (95% CI 3.63–1491.10) in patients with Down
syndrome.
CONCLUSION
Patients with PCAP D who have severe malnutrition, Down syndrome, cardiac
and neurologic abnormalities, and thrombocytopenia should be managed more aggressively to
decrease mortality in these patients.