Hyperglycemia and Red Cell Distribution Width for Prediction of Mortality in Preschool Children with Community Acquired Pneumonia (CAP)

Authors

1 Department of Pediatrics, Minia University Hospital, Al-Minia, Egypt.

2 Department of Clinical Pathology, Minia University Hospital, Al-Minia, Egypt.

Abstract

Background
Community acquired pneumonia (CAP) is a major infectious cause of mortality in preschool children especially in developing countries. Red Cell Distribution Width (RDW) has been associated with poor outcomes of CAP. We aimed to determine whether admission stress hyperglycemia and RDW can predict mortality in preschool children with CAP for early identification of patients at risk of mortality.
Materials and Methods
This is a prospective cohort analysis of a single-center study conducted in the pediatric department and Pediatric Intensive Care Unit (PICU) of Minia Children’s University hospital, El-Minia, Egypt during the period from September 2016 to February 2017. The patients were 1-59 months old children, with community acquired pneumonia. Measurement of admission serum glucose and RDW in addition to complete blood picture was done to all participating children. Assessment of the severity of CAP was done using Pediatric Respiratory Severity Score.
Results: The male gender consumes a high percentage in the Non survivors group (72.7%). The hyperglycemias patients had a statistically significant risk of developing septic shock and respiratory failure than the other groups (23.8%, p<0.001). Also, Admission serum glucose was significantly associated with in hospital mortality (Odds ratio: 1.033, 95%CI: 1.021-1.047, p <0.001). RDW was the most accurate factor for prediction of mortality at the cutoff point >17.4, sensitivity 90.9% and specificity 92.1%, followed by admission serum glucose at cutoff point >110 mg/dl, sensitivity 90.9%, and specificity 78.95 %.
Conclusion
According to the results, elevated RDW and admission hyperglycemia are reliable predictors of mortality in preschool children with community acquired pneumonia.

Keywords