Predictors of Mortality in Children Admitted With Pneumonia to a Tertiary Hospital in Ghana: A Retrospective Cohort Study.

BACKGROUND AND AIM: Pneumonia contributes substantially to the childhood mortality burden in low and middle-income countries (LMICs). Reported predictors of mortality in childhood pneumonia in LMIC are varied. This study aimed to describe predictors of mortality among children with pneumonia in a tertiary hospital in Ghana.

METHODS

A retrospective cohort study that reviewed demographics, clinical features, admission outcomes, and predictors of in-hospital mortality among Ghanaian children admitted with pneumonia. Outcome measures of interest were survival and death.

RESULTS

A total of 630 children were eligible for the study; 394 (62.5%) had medical records that were at least 85% complete. 56% (n = 220) were males. Children who died had a median age of 8 months (IQR: 4-17) and 12 months (IQR: 6-24) for the survivors. Among children with pneumonia, 74% (n = 290) were younger than 24 months, and 73.3% (n = 239) were fully immunized. Mortality rate was 19% (n = 75/394), 34 children died within 24 h of admission, and a cumulative 42 children died within 48 h of admission. Hypoxemia at presentation was more frequent, 38.6% (n = 27), among those who died compared to the survivors, 17% (n = 47). Lower chest wall indrawing (LCI) occurred in both groups (80% vs. 60%, respectively). Predictors of mortality included; presence of diarrhea (aHR = 2.19, 95% CI:1.02-4.71, p = 0.05), hypoxemia (aHR = 2.08, 95% CI:1.09-3.96, p = 0.03).

CONCLUSION

We observed a high burden of pneumonia in very young children. The predictors of mortality were hypoxemia and diarrhea.