Risk Factors of Hypoxemia in Children With Pneumonia

Abstract

Objective To evaluate the risk factors of hypoxemia in children with pneumonia. Methods A retrospective study was conducted for children aged 2 months until 5 years old with pneumonia who were hospitalized from 2015 to 2016 at Dr. Soetomo Hospital. We evaluated comorbidities as risk factors of hypoxemia in children with pneumonia. Hypoxemia was defined as the arterial partial pressure of oxygen below 80 mmHg recorded from arterial blood gas analysis. We used the chi-square test and logistic regression presented as adjusted odds ratio (OR) and 95% confidence interval (95% CI), two tail test with p<0.05. Result One hundred and ninety-six children with pneumonia enrolled in this study, with 62.2 % were male and 75.5% aged 2-12 months old. Hypoxemia was mostly found in children between 2 until 12 months old (OR 2.012, 95% CI 1.000 to 4.046, p=0.048). Univariate analysis revealed sex and almost all comorbidities (malnutrition, down syndrome, neurological disorder, encephalitis, HIV infection, and congenital heart disease) were not risking factors of hypoxemia in children with pneumonia. Logistic regression revealed anemia and severity of pneumonia based on WHO criteria as a risk factor of hypoxemia. Anemia occurred in 89.3% with hypoxemia (adjusted OR 4.984, 95% CI 2.239 to 11.097, p<0.001). Hypoxemia occurred in 93.9% of children with severe pneumonia (the OR 6.313, 95% CI 1.418 to 28.106, p=0.016). Conclusion Anemia and severity of pneumonia were risk factors of hypoxemia in children with pneumonia, aged 2 months until 5 years old