Risk Factors for Pulmonary Complications in Children Hospitalized with Community-Acquired Pneumonia: A Retrospective Cohort Study

Background: Community-acquired pneumonia (CAP) in childhood is an acute lung infection in a child caused by a pathogen originating outside the hospital, i.e., in the community. This disease is a significant cause of illness in developed countries and a major cause of death in developing countries. Objectives: This study aims to assess the factors predicting the incidence of pulmonary complications in children with community-acquired pneumonia. Methods: This study involved all children hospitalized in Zahra Mardani Azari Children's Hospital in Tabriz due to CAP between October 2022 and October 2023. Patients were compared in terms of demographic information, prescription records, medicines prescribed during hospitalization, clinical signs and symptoms, laboratory findings at admission and during hospital treatment; imaging results, and the clinical course of the disease. The study data was analyzed using SPSS version 23 software; and we used logistic regression analysis for identifying the related risk factors. Results: We included 361 patients, of which 104 (28.8%) were in the case group, and 257 (71.2%) were in the control group. The frequent complication was parapneumonic effusion (81.7%) following necrotizing pneumonia (27.9%), empyema (20.2%), and lung abscess (6.7%). Risk factors for pulmonary complications in children with CAP were weight (OR = 1.129), height (OR = 1.112), Body Mass Index (BMI) (OR = 1.112), administration of oral and intravenous acetaminophen during hospitalization (OR = 1.112, 1.209), Tachypnea (OR = 5.178), duration of Fever (OR = 1.290), ESR (OR = 1.312) and HRAD (OR = 3.473). Conclusions: We found that high weight and BMI, receiving acetaminophen during hospitalization, Tachypnea, and Fever duration until hospitalization, as well as high WBC and ESR, were predictive factors of pulmonary complications in children with CAP.