Community-Acquired Pneumonia Hospitalization among Children with Neurologic Disorders

详细信息    查看全文

• 作者：Alexander J. Millman ; MD¹ ; ² ; ^{amillman@cdc.gov" class="auth_mail" title="E-mail the corresponding author} ; Lyn Finelli ; DrPH ; MS¹ ; Anna M. Bramley ; MPH¹ ; Georgina Peacock ; MD ; MPH³ ; Derek J. Williams ; MD ; MPH⁴ ; Sandra R. Arnold ; MD⁵ ; ⁶ ; Carlos G. Grijalva ; MD ; MPH⁴ ; Evan J. Anderson ; MD⁷ ; Jonathan A. McCullers ; MD⁵ ; ⁶ ; ⁸ ; Krow Ampofo ; MD⁹ ; Andrew T. Pavia ; MD⁹ ; Kathryn M. Edwards ; MD⁴ ; Seema Jain ; MD¹
• 关键词：Community-acquired pneumonia ; neurological disorders
• 刊名：The Journal of Pediatrics
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：173
• 期：Complete
• 页码：188-195.e4
• 全文大小：193 K

文摘

To describe and compare the clinical characteristics, outcomes, and etiology of pneumonia among children hospitalized with community-acquired pneumonia (CAP) with neurologic disorders, non-neurologic underlying conditions, and no underlying conditions.

Study design

Children <18 years old hospitalized with clinical and radiographic CAP were enrolled at 3 US children's hospitals. Neurologic disorders included cerebral palsy, developmental delay, Down syndrome, epilepsy, non-Down syndrome chromosomal abnormalities, and spinal cord abnormalities. We compared the epidemiology, etiology, and clinical outcomes of CAP in children with neurologic disorders with those with non-neurologic underlying conditions, and those with no underlying conditions using bivariate, age-stratified, and multivariate logistic regression analyses.

Results

From January 2010-June 2012, 2358 children with radiographically confirmed CAP were enrolled; 280 (11.9%) had a neurologic disorder (52.1% of these individuals also had non-neurologic underlying conditions), 934 (39.6%) had non-neurologic underlying conditions only, and 1144 (48.5%) had no underlying conditions. Children with neurologic disorders were older and more likely to require intensive care unit (ICU) admission than children with non-neurologic underlying conditions and children with no underlying conditions; similar proportions were mechanically ventilated. In age-stratified analysis, children with neurologic disorders were less likely to have a pathogen detected than children with non-neurologic underlying conditions. In multivariate analysis, having a neurologic disorder was associated with ICU admission for children ≥2 years of age.

Conclusions

Children with neurologic disorders hospitalized with CAP were less likely to have a pathogen detected and more likely to be admitted to the ICU than children without neurologic disorders.