Patient characteristics and determinants of outcomes of children admitted with pneumonia to a Paediatric Intensive Care Unit (SLE) in a Tertiary Hospital in Johannesburg

Abstract

Background. Pneumonia is the leading infectious cause of death worldwide. HIV infected and exposed children are at greater risk for developing pneumonia. HIV exposed infants have been said to have a worse outcome than their HIV unexposed counterparts. Objectives. To describe the patient characteristics and determinants of the outcome of children admitted to the paediatric intensive care unit (PICU) with pneumonia. Methods. This was a retrospective review of patients admitted to a PICU between 1 January 2013 and 31 December 2014. Results. One hundred and seven patients were analyzed, of these 65.4% had a normal weight for age. Fifty percent of patients were HIV unexposed, 21.5% HIV infected and 26.2% HIV exposed but uninfected. The HIV infected group had a significantly longer length of stay (p= .011), duration of ventilation (p= .003) and higher mortality (p= .014) when compared to the HIV uninfected group. Likewise compared to HIV exposed but uninfected children, HIV infected had a longer length of stay (p=. 006), duration of ventilation (p= .003) and a greater mortality (p= .038). When the oxygenation index is ≥16, patients had a longer duration of ventilation (p= .037) and they had an increased risk of mortality (p< .001) Multiple regression showed that oxygenation index was the only significant predictor of death. Conclusion. HIV infected children had a significantly higher mortality than both HIV uninfected and HIV exposed but uninfected children. An oxygenation index of greater than 16 is a significant predictor for longer duration of mechanical ventilation and death.