RISK FACTORS OF COMPLICATED COMMUNITY-ACQUIRED PNEUMONIA IN CHILDREN: 1-YEAR DATA FROM A TERTIARY HEALTHCARE CENTER

Introduction: Community-acquired pneumonia(CAP) in children has tended to decrease in recent years with effective vaccination and treatments.However,the frequency of complicated community-acquired pneumonia (CCAP) is gradually increasing.By determining risk factors for the development of CCAP,new approaches for early diagnosis and effective treatment can be determined. Method: Records of 113 patients who were hospitalized due to CAP and CCAP between January 2017 and December 2017 were examined.Demographic characteristics of the patients,comorbid diseases,admission symptoms,physical examination findings,laboratory and imaging results, treatments, hospital stay and treatment response were recorded. Pleural effusion,if empyema developed in patients with CCAP,thoracentesis and/or chest tube insertion,fibrinolytic therapy,and the need for additional surgical intervention were investigated. Results: Our patients had a mean age of 3.6 ± 2.2, 60(53%) were female and 53(47%) were male.93 (82.3%) of the patients were diagnosed with CAP and 18(15.9%) were diagnosed with CCAP.Detection of pleural effusion at the admission of patients in multivariate logistic regression[(OR (95% CI),4.24 (1.77-10.16), p <0.001)] respiratory distress(tachypnea and retraction)[(OR (95% CI) 3.04 (1.30-7.130) ),p <0.001)] and hypoxia (92% and less saO2 measured by pulse oximeter) at admission [(OR (95% CI),: 5.247 (1.58-9.46),p <0.001)] were identified as independent risk factors for diagnosis of CCAP. Discussion: Hypoxia,respiratory distress and imaging pleural effusion are important distinguishing findings for development of complications in patients admitted for CAP. Determining the etiology of CCAPs and early diagnosis and treatment approaches can be established, and protection measures can be taken. With future prospective studies, the causes of CCAP can be determined and preventive measures and new treatment approaches can be developed