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Multicenter Study
. 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

Alexander J Millman  1 , Lyn Finelli  2 , Anna M Bramley  2 , Georgina Peacock  3 , Derek J Williams  4 , Sandra R Arnold  5 , Carlos G Grijalva  4 , Evan J Anderson  6 , Jonathan A McCullers  7 , Krow Ampofo  8 , Andrew T Pavia  8 , Kathryn M Edwards  4 , Seema Jain  2
Affiliations
Multicenter Study

Community-Acquired Pneumonia Hospitalization among Children with Neurologic Disorders

Alexander J Millman et al. J Pediatr. 2016 Jun.

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.

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