ArticlePloS one2013
Predictors and outcome of hypoxemia in severely malnourished children under five with pneumonia: a case control design.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Predictors of inpatient mortality among children hospitalized for severe acute malnutrition: a systematic review and meta-analysis.The American journal of clinical nutrition · 2020Pooled it
- Oxygen therapy for lower respiratory tract infections in children between 3 months and 15 years of age.The Cochrane database of systematic reviews · 2014Pooled it
- Prognosis of clinical pneumonia in undernourished children in rural Gambia.Pneumonia (Nathan Qld.) · 2026Article
- Hypoxemia and its clinical predictors among children with respiratory distress admitted to the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.BMC pediatrics · 2024Article
- Inpatient Morbidity and Mortality of Severely Underweight Children Was Comparable to That of Severely Wasted Children in Dhaka, Bangladesh.The American journal of tropical medicine and hygiene · 2023Article
- 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 : IJID : official publication of the International Society for Infectious Diseases · 2023Article
- Analysis of Risk Factors for Pneumonia Death in ICU Environment Based on Logistic Regression.Journal of environmental and public health · 2022Article
- Prevalence, Predictive Factors, and Outcomes of Respiratory Failure in Children With Pneumonia Admitted in a Developing Country.Frontiers in pediatrics · 2022Article
- Clinical Characteristics and Underlying Factors Related to Recovery from Severe Pneumonia in Under-Five Children with or without Malnutrition Treated at Health Care Facilities in Bangladesh.Children (Basel, Switzerland) · 2021Article
- The clinical characteristics ofTranslational pediatrics · 2021Article
- Article
- Experience With Nosocomial Infection in Children Under 5 Treated in an Urban Diarrheal Treatment Center in Bangladesh.Global pediatric health · 2016Article
- Respiratory risks from household air pollution in low and middle income countries.The Lancet. Respiratory medicine · 2014Review
- Prevalence, clinical features, and outcome of pseudomonas bacteremia in under-five diarrheal children in bangladesh.ISRN microbiology · 2014Article
- Clinical signs of radiologic pneumonia in under-five hypokalemic diarrheal children admitted to an urban hospital in bangladesh.PloS one · 2013Article
- Clinical risk factors of death from pneumonia in children with severe acute malnutrition in an urban critical care ward of Bangladesh.PloS one · 2013Article
- Association of lipid metabolism with pneumonia risk in under-five children in China.Jornal de pediatriaArticle
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is lack of information in the medical literature on predictors of hypoxemia in severely malnourished children with pneumonia, although hypoxemia is common and is often associated with fatal outcome in this population. We explored the predictors of hypoxemia in under-five children who were hospitalized for the management of pneumonia and severe acute malnutrition (SAM).
methodsIn this unmatched case-control design, SAM children of both sexes, aged 0-59 months, admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) with radiological pneumonia and hypoxemia during April 2011 to April 2012 were studied. SAM children with pneumonia and hypoxemia (SpO(2)<90%) constituted the cases (n = 37), and randomly selected SAM children with pneumonia but without hypoxemia constituted controls (n = 111).
resultsThe case-fatality was significantly higher among the cases than the controls (30% vs. 4%; p<0.001). In logistic regression analysis, after adjusting for potential confounders such as nasal flaring, head nodding, inability to drink, and crackles in lungs, fast breathing (95% CI = 1.09-13.55), lower chest wall in-drawing (95% CI = 2.48-43.41), and convulsion at admission (95% CI = 3.14-234.01) were identified as independent predictors of hypoxemia in this population. The sensitivity of fast breathing, lower chest wall in-drawing and convulsion at admission and their 95% confidence intervals (CI) to predict hypoxemia were 84 (67-93)%, 89 (74-96)%, and 19 (9-36)% respectively, and their specificity were 53 (43-63)%, 60 (51-69)% and 98 (93-100)% respectively. CONCLUSION AND SIGNIFICANCE: Fast breathing and lower chest wall in-drawing were the best predictors of hypoxemia in SAM children with pneumonia. There thus, in resources poor settings where pulse oximetry is not available, identification of these simple clinical predictors of hypoxemia in such children could be reliably used for early O(2) supplementation in addition to other appropriate management to reduce morbidity and deaths.
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