Italian journal of pediatrics · 2026
Occurrence of diarrhea in pediatric bronchopneumonia patients: relevance to nursing management.
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Tang Yinyan, Zhang Qian, Yu Tingting
Аннотация
BACKGROUND: Diarrhea represents a frequent complication in pediatric patients with bronchopneumonia. This study was designed to identify independent risk factors for diarrheal complications and to propose evidence-informed nursing interventions.
METHODS: A retrospective cohort study was conducted among 280 hospitalized children with bronchopneumonia. Demographic, anthropometric, laboratory, and treatment-related data were extracted from electronic medical records. Multicollinearity was assessed by variance inflation factor (VIF), and independent risk factors were identified through binary logistic regression with model fit evaluated by the Hosmer-Lemeshow test.
RESULTS: The incidence of diarrhea was 23.57%. Eight independent risk factors were identified: antibiotic duration ≥ 7 days (OR = 3.006), β-lactamase inhibitor combination use (OR = 2.916), combined antibiotic use (OR = 2.401), mixed pulmonary infection (OR = 2.105), age < 5 years (OR = 2.048), weight-for-height/length z-score < - 2 (OR = 1.982), serum albumin < 35 g/L (OR = 1.896), and C-reactive protein ≥ 20 mg/L (OR = 1.845). Probiotic administration was an independent protective factor (OR = 0.849). All VIF values were < 5, and the Hosmer-Lemeshow test indicated adequate model fit (P > 0.05).
CONCLUSION: Diarrhea in children with bronchopneumonia is associated with multiple clinical and therapeutic variables, with β-lactamase inhibitor combinations and prolonged antibiotic therapy conferring the highest risk. These findings provide a hypothesis-generating foundation for risk-stratified nursing strategies to reduce diarrheal complications. However, given the retrospective design and the inability to distinguish antibiotic-associated diarrhea from infectious diarrhea, the identified associations should be interpreted cautiously, and any derived clinical recommendations require prospective validation.
METHODS: A retrospective cohort study was conducted among 280 hospitalized children with bronchopneumonia. Demographic, anthropometric, laboratory, and treatment-related data were extracted from electronic medical records. Multicollinearity was assessed by variance inflation factor (VIF), and independent risk factors were identified through binary logistic regression with model fit evaluated by the Hosmer-Lemeshow test.
RESULTS: The incidence of diarrhea was 23.57%. Eight independent risk factors were identified: antibiotic duration ≥ 7 days (OR = 3.006), β-lactamase inhibitor combination use (OR = 2.916), combined antibiotic use (OR = 2.401), mixed pulmonary infection (OR = 2.105), age < 5 years (OR = 2.048), weight-for-height/length z-score < - 2 (OR = 1.982), serum albumin < 35 g/L (OR = 1.896), and C-reactive protein ≥ 20 mg/L (OR = 1.845). Probiotic administration was an independent protective factor (OR = 0.849). All VIF values were < 5, and the Hosmer-Lemeshow test indicated adequate model fit (P > 0.05).
CONCLUSION: Diarrhea in children with bronchopneumonia is associated with multiple clinical and therapeutic variables, with β-lactamase inhibitor combinations and prolonged antibiotic therapy conferring the highest risk. These findings provide a hypothesis-generating foundation for risk-stratified nursing strategies to reduce diarrheal complications. However, given the retrospective design and the inability to distinguish antibiotic-associated diarrhea from infectious diarrhea, the identified associations should be interpreted cautiously, and any derived clinical recommendations require prospective validation.