Risk Stratification for Complications in Patients Hospitalized With Community-Acquired Pneumonia.

AIM: Community-acquired pneumonia (CAP) remains a major cause of morbidity in children. Although severity assessment tools are available, they are not specifically designed to predict the development of a broad spectrum of pulmonary and systemic complications. This study aimed to identify admission factors associated with complicated pneumonia (CP) in hospitalized children with CAP and to develop a practical risk scoring model for early risk stratification.

METHODS

Patients hospitalized with CAP were classified into two categories: uncomplicated CAP and complicated pneumonia. Independent predictors for the development of complicated pneumonia were identified.

RESULTS

Multivariate logistic regression identified the following as independent risk factors for complicated pneumonia: older age (OR: 1.011; p < 0.001), hypotension (OR: 28.083; p < 0.001), altered mental status (OR: 5.033; p = 0.024), low haemoglobin values (OR: 0.835; p = 0.015), leukopenia (OR: 3.197; p = 0.040), increased neutrophil-to-lymphocyte ratio levels (OR: 1.045; p = 0.049), hyponatremia (OR: 2.840; p < 0.001), hypoalbuminemia (OR: 6.489; p < 0.001) and increased C-reactive protein levels (OR: 1.034; p = 0.039). The scoring system demonstrated a sensitivity of 82% and a specificity of 79%.

CONCLUSIONS

We identified admission characteristics associated with the development of pulmonary and systemic complications in hospitalized children with CAP and developed a complication-focused risk scoring model based on routinely available parameters. The model showed good performance within this retrospective cohort and may support early risk stratification. Prospective multicentre validation is required to confirm its generalizability and clinical utility.