Predictors of Mortality in Children Admitted With Pneumonia to a Tertiary Hospital in Ghana: A Retrospective Cohort Study
Sandra Kwarteng Owusu, Richard Kwaku Kwarteng Owusu, Birgit Agyeiwah Baah, Justice Sylverken, Nicholas Karikari Mensah, Naomi Dianne Adjetey, Serwah Bonsu Asafo‐Agyei, Larko Dormeyo Owusu, John Adabie Appiah, Samuel Blay Nguah, Emmanuel Ameyaw, Naana Wireko‐Brobby, Joseph Marfo, Augustine Kwame Afful, Lilliam Ambroggio, Daniel Ansong, Joyce Ashong, Lord NkansahABSTRACT
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.