In-hospital mortality risk stratification in children aged under 5 years with pneumonia with or without pulse oximetry: A secondary analysis of the Pneumonia REsearch Partnership to Assess WHO REcommendations (PREPARE) dataset

Shubhada Hooli; Carina King; Eric D. McCollum; Tim Colbourn; Norman Lufesi; Charles Mwansambo; Christopher J. Gregory; Somsak Thamthitiwat; Clare Cutland; Shabir Ahmed Madhi; Marta C. Nunes; Bradford D. Gessner; Tabish Hazir; Joseph L. Mathew; Emmanuel Addo-Yobo; Noel Chisaka; Mumtaz Hassan; Patricia L. Hibberd; Prakash Jeena; Juan M. Lozano; William B. MacLeod; Archana Patel; Donald M. Thea; Ngoc Tuong Vy Nguyen; Akram Zaman Akramuzzaman; Raul O. Ruvinsky; Marilla Lucero; Cissy B. Kartasasmita; Claudia Turner; Rai Asghar; Salem Banajeh; Imran Iqbal; Irene Maulen-Radovan; Greta Mino-Leon; Samir K. Saha; Mathuram Santosham; Sunit Singhi; Shally Awasthi; Ashish Bavdekar; Monidarin Chou; Pagbajabyn Nymadawa; Jean-William Pape; Glaucia Paranhos-Baccala; Valentina Sanchez Picot; Mala Rakoto-Andrianarivelo; Vanessa Rouzier; Graciela Russomando; Mariam Sylla; Philippe Vanhems; Jianwei Wang; Sudha Basnet; Tor A. Strand; Mark I. Neuman; Luis Martinez Arroyo; Marcela Echavarria; Shinjini Bhatnagar; Nitya Wadhwa; Rakesh Lodha; Satinder Aneja; Angela Gentile; Mandeep Chadha; Siddhivinayak Hirve; Kerry-Ann F. O'Grady; Alexey W. Clara; Chris A. Rees; Harry Campbell; Harish Nair; Jennifer Falconer; Linda J. Williams; Margaret Horne; Shamim A. Qazi; Yasir Bin Nisar

doi:10.1016/j.ijid.2023.02.005

In-hospital mortality risk stratification in children aged under 5 years with pneumonia with or without pulse oximetry: A secondary analysis of the Pneumonia REsearch Partnership to Assess WHO REcommendations (PREPARE) dataset

Shubhada Hooli, Carina King, Eric D. McCollum, Tim Colbourn, Norman Lufesi, Charles Mwansambo, Christopher J. Gregory, Somsak Thamthitiwat, Clare Cutland, Shabir Ahmed Madhi, Marta C. Nunes, Bradford D. Gessner, Tabish Hazir, Joseph L. Mathew, Emmanuel Addo-Yobo, Noel Chisaka, Mumtaz Hassan, Patricia L. Hibberd, Prakash Jeena, Juan M. LozanoWilliam B. MacLeod, Archana Patel, Donald M. Thea, Ngoc Tuong Vy Nguyen, Akram Zaman Akramuzzaman, Raul O. Ruvinsky, Marilla Lucero, Cissy B. Kartasasmita, Claudia Turner, Rai Asghar, Salem Banajeh, Imran Iqbal, Irene Maulen-Radovan, Greta Mino-Leon, Samir K. Saha, Mathuram Santosham, Sunit Singhi, Shally Awasthi, Ashish Bavdekar, Monidarin Chou, Pagbajabyn Nymadawa, Jean-William Pape, Glaucia Paranhos-Baccala, Valentina Sanchez Picot, Mala Rakoto-Andrianarivelo, Vanessa Rouzier, Graciela Russomando, Mariam Sylla, Philippe Vanhems, Jianwei Wang, Sudha Basnet, Tor A. Strand, Mark I. Neuman, Luis Martinez Arroyo, Marcela Echavarria, Shinjini Bhatnagar, Nitya Wadhwa, Rakesh Lodha, Satinder Aneja, Angela Gentile, Mandeep Chadha, Siddhivinayak Hirve, Kerry-Ann F. O'Grady, Alexey W. Clara, Chris A. Rees, Harry Campbell, Harish Nair, Jennifer Falconer, Linda J. Williams, Margaret Horne, Shamim A. Qazi, Yasir Bin Nisar

Research output: Contribution to journal › Article › peer-review

10 Citations (Scopus)

Abstract

Objectives

We determined the pulse oximetry benefit in pediatric pneumonia mortality risk stratification and chest-indrawing pneumonia in-hospital mortality risk factors.

Methods

We report the characteristics and in-hospital pneumonia-related mortality of children aged 2-59 months who were included in the Pneumonia Research Partnership to Assess WHO Recommendations dataset. We developed multivariable logistic regression models of chest-indrawing pneumonia to identify mortality risk factors.

Results

Among 285,839 children, 164,244 (57.5%) from hospital-based studies were included. Pneumonia case fatality risk (CFR) without pulse oximetry measurement was higher than with measurement (5.8%, 95% confidence interval [CI] 5.6-5.9% vs 2.1%, 95% CI 1.9-2.4%). One in five children with chest-indrawing pneumonia was hypoxemic (19.7%, 95% CI 19.0-20.4%), and the hypoxemic CFR was 10.3% (95% CI 9.1-11.5%). Other mortality risk factors were younger age (either 2-5 months [adjusted odds ratio (aOR) 9.94, 95% CI 6.67-14.84] or 6-11 months [aOR 2.67, 95% CI 1.71-4.16]), moderate malnutrition (aOR 2.41, 95% CI 1.87-3.09), and female sex (aOR 1.82, 95% CI 1.43-2.32).

Conclusion

Children with a pulse oximetry measurement had a lower CFR. Many children hospitalized with chest-indrawing pneumonia were hypoxemic and one in 10 died. Young age and moderate malnutrition were risk factors for in-hospital chest-indrawing pneumonia-related mortality. Pulse oximetry should be integrated in pneumonia hospital care for children under 5 years.

Original language	English
Pages (from-to)	240-250
Number of pages	11
Journal	International Journal of Infectious Diseases
Volume	129
Early online date	3 Mar 2023
DOIs	https://doi.org/10.1016/j.ijid.2023.02.005
Publication status	Published - 3 Mar 2023

Keywords

Chest indrawing
Child
Danger sign
Pneumonia
Pulse oximetry
Under 5

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Hooli, S., King, C., McCollum, E. D., Colbourn, T., Lufesi, N., Mwansambo, C., Gregory, C. J., Thamthitiwat, S., Cutland, C., Madhi, S. A., Nunes, M. C., Gessner, B. D., Hazir, T., Mathew, J. L., Addo-Yobo, E., Chisaka, N., Hassan, M., Hibberd, P. L., Jeena, P., ... Nisar, Y. B. (2023). In-hospital mortality risk stratification in children aged under 5 years with pneumonia with or without pulse oximetry: A secondary analysis of the Pneumonia REsearch Partnership to Assess WHO REcommendations (PREPARE) dataset. International Journal of Infectious Diseases, 129, 240-250. https://doi.org/10.1016/j.ijid.2023.02.005

@article{91a9f2ffde8f4b2dbfc2306fd83cd5ed,

title = "In-hospital mortality risk stratification in children aged under 5 years with pneumonia with or without pulse oximetry: A secondary analysis of the Pneumonia REsearch Partnership to Assess WHO REcommendations (PREPARE) dataset",

abstract = "Objectives We determined the pulse oximetry benefit in pediatric pneumonia mortality risk stratification and chest-indrawing pneumonia in-hospital mortality risk factors. MethodsWe report the characteristics and in-hospital pneumonia-related mortality of children aged 2-59 months who were included in the Pneumonia Research Partnership to Assess WHO Recommendations dataset. We developed multivariable logistic regression models of chest-indrawing pneumonia to identify mortality risk factors. ResultsAmong 285,839 children, 164,244 (57.5\%) from hospital-based studies were included. Pneumonia case fatality risk (CFR) without pulse oximetry measurement was higher than with measurement (5.8\%, 95\% confidence interval [CI] 5.6-5.9\% vs 2.1\%, 95\% CI 1.9-2.4\%). One in five children with chest-indrawing pneumonia was hypoxemic (19.7\%, 95\% CI 19.0-20.4\%), and the hypoxemic CFR was 10.3\% (95\% CI 9.1-11.5\%). Other mortality risk factors were younger age (either 2-5 months [adjusted odds ratio (aOR) 9.94, 95\% CI 6.67-14.84] or 6-11 months [aOR 2.67, 95\% CI 1.71-4.16]), moderate malnutrition (aOR 2.41, 95\% CI 1.87-3.09), and female sex (aOR 1.82, 95\% CI 1.43-2.32). ConclusionChildren with a pulse oximetry measurement had a lower CFR. Many children hospitalized with chest-indrawing pneumonia were hypoxemic and one in 10 died. Young age and moderate malnutrition were risk factors for in-hospital chest-indrawing pneumonia-related mortality. Pulse oximetry should be integrated in pneumonia hospital care for children under 5 years.",

keywords = "Chest indrawing, Child, Danger sign, Pneumonia, Pulse oximetry, Under 5",

author = "Shubhada Hooli and Carina King and McCollum, \{Eric D.\} and Tim Colbourn and Norman Lufesi and Charles Mwansambo and Gregory, \{Christopher J.\} and Somsak Thamthitiwat and Clare Cutland and Madhi, \{Shabir Ahmed\} and Nunes, \{Marta C.\} and Gessner, \{Bradford D.\} and Tabish Hazir and Mathew, \{Joseph L.\} and Emmanuel Addo-Yobo and Noel Chisaka and Mumtaz Hassan and Hibberd, \{Patricia L.\} and Prakash Jeena and Lozano, \{Juan M.\} and MacLeod, \{William B.\} and Archana Patel and Thea, \{Donald M.\} and Nguyen, \{Ngoc Tuong Vy\} and Akramuzzaman, \{Akram Zaman\} and Ruvinsky, \{Raul O.\} and Marilla Lucero and Kartasasmita, \{Cissy B.\} and Claudia Turner and Rai Asghar and Salem Banajeh and Imran Iqbal and Irene Maulen-Radovan and Greta Mino-Leon and Saha, \{Samir K.\} and Mathuram Santosham and Sunit Singhi and Shally Awasthi and Ashish Bavdekar and Monidarin Chou and Pagbajabyn Nymadawa and Jean-William Pape and Glaucia Paranhos-Baccala and Picot, \{Valentina Sanchez\} and Mala Rakoto-Andrianarivelo and Vanessa Rouzier and Graciela Russomando and Mariam Sylla and Philippe Vanhems and Jianwei Wang and Sudha Basnet and Strand, \{Tor A.\} and Neuman, \{Mark I.\} and Arroyo, \{Luis Martinez\} and Marcela Echavarria and Shinjini Bhatnagar and Nitya Wadhwa and Rakesh Lodha and Satinder Aneja and Angela Gentile and Mandeep Chadha and Siddhivinayak Hirve and O'Grady, \{Kerry-Ann F.\} and Clara, \{Alexey W.\} and Rees, \{Chris A.\} and Harry Campbell and Harish Nair and Jennifer Falconer and Williams, \{Linda J.\} and Margaret Horne and Qazi, \{Shamim A.\} and Nisar, \{Yasir Bin\}",

year = "2023",

month = mar,

day = "3",

doi = "10.1016/j.ijid.2023.02.005",

language = "English",

volume = "129",

pages = "240--250",

journal = "International Journal of Infectious Diseases",

issn = "1201-9712",

publisher = "Elsevier B.V.",

}

Hooli, S, King, C, McCollum, ED, Colbourn, T, Lufesi, N, Mwansambo, C, Gregory, CJ, Thamthitiwat, S, Cutland, C, Madhi, SA, Nunes, MC, Gessner, BD, Hazir, T, Mathew, JL, Addo-Yobo, E, Chisaka, N, Hassan, M, Hibberd, PL, Jeena, P, Lozano, JM, MacLeod, WB, Patel, A, Thea, DM, Nguyen, NTV, Akramuzzaman, AZ, Ruvinsky, RO, Lucero, M, Kartasasmita, CB, Turner, C, Asghar, R, Banajeh, S, Iqbal, I, Maulen-Radovan, I, Mino-Leon, G, Saha, SK, Santosham, M, Singhi, S, Awasthi, S, Bavdekar, A, Chou, M, Nymadawa, P, Pape, J-W, Paranhos-Baccala, G, Picot, VS, Rakoto-Andrianarivelo, M, Rouzier, V, Russomando, G, Sylla, M, Vanhems, P, Wang, J, Basnet, S, Strand, TA, Neuman, MI, Arroyo, LM, Echavarria, M, Bhatnagar, S, Wadhwa, N, Lodha, R, Aneja, S, Gentile, A, Chadha, M, Hirve, S, O'Grady, K-AF, Clara, AW, Rees, CA, Campbell, H, Nair, H, Falconer, J, Williams, LJ, Horne, M, Qazi, SA & Nisar, YB 2023, 'In-hospital mortality risk stratification in children aged under 5 years with pneumonia with or without pulse oximetry: A secondary analysis of the Pneumonia REsearch Partnership to Assess WHO REcommendations (PREPARE) dataset', International Journal of Infectious Diseases, vol. 129, pp. 240-250. https://doi.org/10.1016/j.ijid.2023.02.005

In-hospital mortality risk stratification in children aged under 5 years with pneumonia with or without pulse oximetry: A secondary analysis of the Pneumonia REsearch Partnership to Assess WHO REcommendations (PREPARE) dataset. / Hooli, Shubhada; King, Carina; McCollum, Eric D. et al.
In: International Journal of Infectious Diseases, Vol. 129, 03.03.2023, p. 240-250.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - In-hospital mortality risk stratification in children aged under 5 years with pneumonia with or without pulse oximetry: A secondary analysis of the Pneumonia REsearch Partnership to Assess WHO REcommendations (PREPARE) dataset

AU - Hooli, Shubhada

AU - King, Carina

AU - McCollum, Eric D.

AU - Colbourn, Tim

AU - Lufesi, Norman

AU - Mwansambo, Charles

AU - Gregory, Christopher J.

AU - Thamthitiwat, Somsak

AU - Cutland, Clare

AU - Madhi, Shabir Ahmed

AU - Nunes, Marta C.

AU - Gessner, Bradford D.

AU - Hazir, Tabish

AU - Mathew, Joseph L.

AU - Addo-Yobo, Emmanuel

AU - Chisaka, Noel

AU - Hassan, Mumtaz

AU - Hibberd, Patricia L.

AU - Jeena, Prakash

AU - Lozano, Juan M.

AU - MacLeod, William B.

AU - Patel, Archana

AU - Thea, Donald M.

AU - Nguyen, Ngoc Tuong Vy

AU - Akramuzzaman, Akram Zaman

AU - Ruvinsky, Raul O.

AU - Lucero, Marilla

AU - Kartasasmita, Cissy B.

AU - Turner, Claudia

AU - Asghar, Rai

AU - Banajeh, Salem

AU - Iqbal, Imran

AU - Maulen-Radovan, Irene

AU - Mino-Leon, Greta

AU - Saha, Samir K.

AU - Santosham, Mathuram

AU - Singhi, Sunit

AU - Awasthi, Shally

AU - Bavdekar, Ashish

AU - Chou, Monidarin

AU - Nymadawa, Pagbajabyn

AU - Pape, Jean-William

AU - Paranhos-Baccala, Glaucia

AU - Picot, Valentina Sanchez

AU - Rakoto-Andrianarivelo, Mala

AU - Rouzier, Vanessa

AU - Russomando, Graciela

AU - Sylla, Mariam

AU - Vanhems, Philippe

AU - Wang, Jianwei

AU - Basnet, Sudha

AU - Strand, Tor A.

AU - Neuman, Mark I.

AU - Arroyo, Luis Martinez

AU - Echavarria, Marcela

AU - Bhatnagar, Shinjini

AU - Wadhwa, Nitya

AU - Lodha, Rakesh

AU - Aneja, Satinder

AU - Gentile, Angela

AU - Chadha, Mandeep

AU - Hirve, Siddhivinayak

AU - O'Grady, Kerry-Ann F.

AU - Clara, Alexey W.

AU - Rees, Chris A.

AU - Campbell, Harry

AU - Nair, Harish

AU - Falconer, Jennifer

AU - Williams, Linda J.

AU - Horne, Margaret

AU - Qazi, Shamim A.

AU - Nisar, Yasir Bin

PY - 2023/3/3

Y1 - 2023/3/3

N2 - Objectives We determined the pulse oximetry benefit in pediatric pneumonia mortality risk stratification and chest-indrawing pneumonia in-hospital mortality risk factors. MethodsWe report the characteristics and in-hospital pneumonia-related mortality of children aged 2-59 months who were included in the Pneumonia Research Partnership to Assess WHO Recommendations dataset. We developed multivariable logistic regression models of chest-indrawing pneumonia to identify mortality risk factors. ResultsAmong 285,839 children, 164,244 (57.5%) from hospital-based studies were included. Pneumonia case fatality risk (CFR) without pulse oximetry measurement was higher than with measurement (5.8%, 95% confidence interval [CI] 5.6-5.9% vs 2.1%, 95% CI 1.9-2.4%). One in five children with chest-indrawing pneumonia was hypoxemic (19.7%, 95% CI 19.0-20.4%), and the hypoxemic CFR was 10.3% (95% CI 9.1-11.5%). Other mortality risk factors were younger age (either 2-5 months [adjusted odds ratio (aOR) 9.94, 95% CI 6.67-14.84] or 6-11 months [aOR 2.67, 95% CI 1.71-4.16]), moderate malnutrition (aOR 2.41, 95% CI 1.87-3.09), and female sex (aOR 1.82, 95% CI 1.43-2.32). ConclusionChildren with a pulse oximetry measurement had a lower CFR. Many children hospitalized with chest-indrawing pneumonia were hypoxemic and one in 10 died. Young age and moderate malnutrition were risk factors for in-hospital chest-indrawing pneumonia-related mortality. Pulse oximetry should be integrated in pneumonia hospital care for children under 5 years.

AB - Objectives We determined the pulse oximetry benefit in pediatric pneumonia mortality risk stratification and chest-indrawing pneumonia in-hospital mortality risk factors. MethodsWe report the characteristics and in-hospital pneumonia-related mortality of children aged 2-59 months who were included in the Pneumonia Research Partnership to Assess WHO Recommendations dataset. We developed multivariable logistic regression models of chest-indrawing pneumonia to identify mortality risk factors. ResultsAmong 285,839 children, 164,244 (57.5%) from hospital-based studies were included. Pneumonia case fatality risk (CFR) without pulse oximetry measurement was higher than with measurement (5.8%, 95% confidence interval [CI] 5.6-5.9% vs 2.1%, 95% CI 1.9-2.4%). One in five children with chest-indrawing pneumonia was hypoxemic (19.7%, 95% CI 19.0-20.4%), and the hypoxemic CFR was 10.3% (95% CI 9.1-11.5%). Other mortality risk factors were younger age (either 2-5 months [adjusted odds ratio (aOR) 9.94, 95% CI 6.67-14.84] or 6-11 months [aOR 2.67, 95% CI 1.71-4.16]), moderate malnutrition (aOR 2.41, 95% CI 1.87-3.09), and female sex (aOR 1.82, 95% CI 1.43-2.32). ConclusionChildren with a pulse oximetry measurement had a lower CFR. Many children hospitalized with chest-indrawing pneumonia were hypoxemic and one in 10 died. Young age and moderate malnutrition were risk factors for in-hospital chest-indrawing pneumonia-related mortality. Pulse oximetry should be integrated in pneumonia hospital care for children under 5 years.

KW - Chest indrawing

KW - Child

KW - Danger sign

KW - Pneumonia

KW - Pulse oximetry

KW - Under 5

U2 - 10.1016/j.ijid.2023.02.005

DO - 10.1016/j.ijid.2023.02.005

M3 - Article

SN - 1201-9712

VL - 129

SP - 240

EP - 250

JO - International Journal of Infectious Diseases

JF - International Journal of Infectious Diseases

ER -

Hooli S, King C, McCollum ED, Colbourn T, Lufesi N, Mwansambo C et al. In-hospital mortality risk stratification in children aged under 5 years with pneumonia with or without pulse oximetry: A secondary analysis of the Pneumonia REsearch Partnership to Assess WHO REcommendations (PREPARE) dataset. International Journal of Infectious Diseases. 2023 Mar 3;129:240-250. Epub 2023 Mar 3. doi: 10.1016/j.ijid.2023.02.005