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.