Mortality Risk Factors Among Hospitalized Children with Severe Pertussis.

Background: Some children hospitalized for severe pertussis infection require intensive care; moreover, some children die because of disease deterioration alone or in combination with other complications. The purpose of this study was to identify mortality risk factors among hospitalized children with severe pertussis. Methods: : This study evaluated the medical records of 144 hospitalized children with severepertussis at the Guangzhou Women and Children’s Medical Center between January 2016 and December 2019. Results: : The median age of patients was 2 months (IQR, 1–4 months), with 90.1% of the patients aged <6 months and 56.9% of the patients aged <3 months. A total of 13 patients died, and the mortality of severe pertussis was 34.2%, with patients younger than 6 weeks accounting for 76.9% of the deaths. On multivariate analysis, the independent risk factors for death were WBC >70.0×10 9 /L (odds ratio [OR], 230.66; 95% confidence interval [CI], 5.16–10319.09 P = 0.005) and pulmonary hypertension (PH) (OR, 323.29; 95% CI, 16.01–6529.42; P<0.001). Conclusion: Severe pertussis mainly occurred in children aged <3 months. The mortality of severe pertussis was 34.2%, with patients younger than 6 weeks accounting for the majority of the deaths. We recommend the first dose of diphtheria-tetanus-pertussis (DTP) should be advanced to the age of 2 months or even 6 weeks. The presence of a WBC >70.0×10 9 /L and PH were the prognostic variables independently associated with death.