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. 2021 Aug 25;40(9):S40–S49. doi: 10.1097/INF.0000000000002652

TABLE 2.

Clinical and Laboratory Factors Associated With In-hospital Mortality Among All 514 HIV-uninfected Under 5-Year-Old Zambian Children With Severe and Very Severe Pneumonia on Admission

Characteristic All Cases Fatal Cases Nonfatal Cases aOR* P Value*
Total 514 (100) 76 (100) 438 (100)
Female 234 (45.5) 41 (53.9) 193 (44.1) 1.5 (0.9–2.4) 0.11
Very severe pneumonia 160 (31.1) 45 (59.2) 115 (26.3) 4.2 (2.5–6.9) <0.0001
Age <1 year 399 (77.6) 62 (81.6) 337 (76.9) 1.3 (0.7–2.5) 0.3718
Weight for age <−2 SD 160 (31.2) 47 (61.8) 113 (25.9) 4.9 (2.9–8.2) <0.0001
Weight for height <−2 SD 93 (19.2) 23 (34.9) 70 (16.8) 2.9 (1.6–5.2) 0.0003
Premature† 19 (4.8) 6 (9.8) 13 (3.9) 2.8 (1.0–7.6) 0.048
HIV exposure status
 Exposed/uninfected 134 (26.1) 29 (38.2) 105 (24.0) 2.1 (1.3–3.6) <0.0001
 Unexposed/uninfected 369 (71.8) 41 (53.9) 328 (74.9) Ref
 Unknown 11 (2.1) 6 (7.9) 5 (1.1) 10.1 (2.9–34.9)
4 or more people sleeping in the same room 84 (16.4) 22 (29.3) 62 (14.2) 2.5 (1.4–4.5) 0.0012
Duration of illness‡
 ≤2 d 181 (35.4) 22 (29.7) 159 (36.4) Ref 0.012
 3–5 d 220 (43.1) 26 (35.1) 194 (44.4) 1.0 (0.5–1.8)
 >5 d 110 (21.5) 26 (35.1) 84 (19.2) 2.2 (1.2–4.1)
Duration in hospital
 ≤2 d 154 (30.0) 57 (75.0) 97 (22.2) Ref <0.0001
 3–5 d 174 (33.9) 8 (10.5) 166 (38.0) 0.07 (0.03–0.2)
 >5 d 185 (36.1) 11 (14.5) 174 (39.8) 0.10 (0.05–0.2)
CXR positive§
 Consolidation or other infiltrate 208 (56.7) 23 (67.6) 185 (55.6) 1.7 (0.8–3.5) 0.19
 Normal 159 (43.3) 11 (32.4) 148 (44.4) Ref
Runny nose 180 (35.0) 11 (14.5) 169 (38.6) 0.2 (0.1–0.5) <0.0001
Hypoxia¶ 185 (36.1) 46 (60.5) 139 (31.8) 3.3 (2.0–5.4) <0.0001
Lethargy 64 (12.5) 32 (42.1) 32 (7.3) 10.2 (5.6–18.5) <0.0001
Deep breathing 36 (7.0) 12 (15.8) 24 (5.5) 3.4 (1.6–7.2) 0.0013
Observed cough 349 (67.9) 37 (48.7) 312 (71.2) 0.4 (0.2–0.6) 0.0001
Observed grunting 137 (26.7) 36 (47.4) 101 (23.1) 3.0 (1.8–4.9) <0.0001
Severe anemia‖ 41 (8.2) 10 (14.3) 31 (7.2) 2.2 (1.0–4.8) 0.041
Leukocytosis** 213 (42.7) 38 (53.5) 175 (40.9) 1.7 (1.0–2.9) 0.032

*aOR and P-values adjusted for age in months.

†Prematurity defined as <37 weeks gestational age or maternal report of premature.

‡Duration of illness defined as duration (in days) of cough, wheeze, fever or difficulty breathing, whichever is longest.

§Restricted to those with an interpretable CXR (N = 34 for fatal cases and N = 333 for nonfatal cases). CXR obtained at admission.

¶Hypoxemia defined as oxygen saturation <90% or on supplemental oxygen if a room air oxygen saturation reading was not available.

‖Severe anemia defined as hemoglobin ≤7.5 g/dL.

**Leukocytosis count defined as >15 × 109 cells/L for children 1–11 months and >13 × 109 cells/L for children 12–59 months.