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J Pediatr. 2016 Jun;173:188-195.e4. doi: 10.1016/j.jpeds.2016.02.049. Epub 2016 Mar 23.

Community-Acquired Pneumonia Hospitalization among Children with Neurologic Disorders.

Author information

1
Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA. Electronic address: amillman@cdc.gov.
2
Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA.
3
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.
4
Vanderbilt University School of Medicine, Nashville, TN.
5
Le Bonheur Children's Hospital, Memphis, TN; University of Tennessee Health Science Center, Memphis, TN.
6
Emory University School of Medicine, Atlanta, GA.
7
Le Bonheur Children's Hospital, Memphis, TN; University of Tennessee Health Science Center, Memphis, TN; St. Jude Children's Research Hospital, Memphis, TN.
8
University of Utah Health Sciences Center, Salt Lake City, UT.

Abstract

OBJECTIVE:

To describe and compare the clinical characteristics, outcomes, and etiology of pneumonia among children hospitalized with community-acquired pneumonia (CAP) with neurologic disorders, non-neurologic underlying conditions, and no underlying conditions.

STUDY DESIGN:

Children <18 years old hospitalized with clinical and radiographic CAP were enrolled at 3 US children's hospitals. Neurologic disorders included cerebral palsy, developmental delay, Down syndrome, epilepsy, non-Down syndrome chromosomal abnormalities, and spinal cord abnormalities. We compared the epidemiology, etiology, and clinical outcomes of CAP in children with neurologic disorders with those with non-neurologic underlying conditions, and those with no underlying conditions using bivariate, age-stratified, and multivariate logistic regression analyses.

RESULTS:

From January 2010-June 2012, 2358 children with radiographically confirmed CAP were enrolled; 280 (11.9%) had a neurologic disorder (52.1% of these individuals also had non-neurologic underlying conditions), 934 (39.6%) had non-neurologic underlying conditions only, and 1144 (48.5%) had no underlying conditions. Children with neurologic disorders were older and more likely to require intensive care unit (ICU) admission than children with non-neurologic underlying conditions and children with no underlying conditions; similar proportions were mechanically ventilated. In age-stratified analysis, children with neurologic disorders were less likely to have a pathogen detected than children with non-neurologic underlying conditions. In multivariate analysis, having a neurologic disorder was associated with ICU admission for children ≥2 years of age.

CONCLUSIONS:

Children with neurologic disorders hospitalized with CAP were less likely to have a pathogen detected and more likely to be admitted to the ICU than children without neurologic disorders.

KEYWORDS:

Community-acquired pneumonia; neurological disorders

PMID:
27017483
PMCID:
PMC4897771
DOI:
10.1016/j.jpeds.2016.02.049
[Indexed for MEDLINE]
Free PMC Article

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