Dataset Information

An exploration of mortality risk factors in non-severe pneumonia in children using clinical data from Kenya.

ABSTRACT:

Background

Childhood pneumonia is the leading infectious cause of mortality in children younger than 5 years old. Recent updates to World Health Organization pneumonia guidelines recommend outpatient care for a population of children previously classified as high risk. This revision has been challenged by policymakers in Africa, where mortality related to pneumonia is higher than in other regions and often complicated by comorbidities. This study aimed to identify factors that best discriminate inpatient mortality risk in non-severe pneumonia and explore whether these factors offer any added benefit over the current criteria used to identify children with pneumonia requiring inpatient care.

Methods

We undertook a retrospective cohort study of children aged 2-59 months admitted with a clinical diagnosis of pneumonia at 14 public hospitals in Kenya between February 2014 and February 2016. Using machine learning techniques, we analysed whether clinical characteristics and common comorbidities increased the risk of inpatient mortality for non-severe pneumonia. The topmost risk factors were subjected to decision curve analysis to explore if using them as admission criteria had any net benefit above the current criteria.

Results

Out of 16,162 children admitted with pneumonia during the study period, 10,687 were eligible for subsequent analysis. Inpatient mortality within this non-severe group was 252/10,687 (2.36%). Models demonstrated moderately good performance; the partial least squares discriminant analysis model had higher sensitivity for predicting mortality in comparison to logistic regression. Elevated respiratory rate (?70 bpm), age 2-11 months and weight-for-age Z-score (WAZ)?ConclusionsChildren with non-severe pneumonia aged 2-11 months or with respiratory rate???70 bpm or very low WAZ experience risks of inpatient mortality comparable to severe pneumonia. Inpatient care is warranted in these high-risk groups of children.

SUBMITTER: Tuti T

PROVIDER: S-EPMC5682642 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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Publications

An exploration of mortality risk factors in non-severe pneumonia in children using clinical data from Kenya.

Tuti Timothy T Agweyu Ambrose A Mwaniki Paul P Peek Niels N English Mike M

BMC medicine 20171113 1

<h4>Background</h4>Childhood pneumonia is the leading infectious cause of mortality in children younger than 5 years old. Recent updates to World Health Organization pneumonia guidelines recommend outpatient care for a population of children previously classified as high risk. This revision has been challenged by policymakers in Africa, where mortality related to pneumonia is higher than in other regions and often complicated by comorbidities. This study aimed to identify factors that best discr ...[more]

PMID: 29129186

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Dataset Information

An exploration of mortality risk factors in non-severe pneumonia in children using clinical data from Kenya.

Background

Methods

Results

Publications

An exploration of mortality risk factors in non-severe pneumonia in children using clinical data from Kenya.

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