Karthik, K (2020) Application of a Prognostic Scale to Predict the Mortality of Children Hospitalised with Community Acquired Pneumonia in a Tertiary Care Hospital. Masters thesis, Madras Medical College, Chennai.
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Abstract
Pneumonia is the most common infectious disease requiring ICU admission worldwide. · Early admission to intensive care and combination of antibiotics can reduce the mortality of pneumonia. · Various mortality predictors like need for inotrope, need for assisted ventilation, acute renal failure, acute liver failure are independent mortality predictors of severe pneumonia. · Pneumococcal pneumonia is the most common cause of pneumonia worldwide which can be prevented by pneumococcal conjugate 13 and pneumococcal polysaccharide vaccine PPV23. · As infants were more prone for pneumonia, a multimodal approach is needed to manage these children as they have rapid deterioration course. · PIRO is acting as a better predictor of mortality in my study as compared to various studies. OBJECTIVE: The association of PIRO score and its prediction on mortality in children hospitalized with community acquired pneumonia. METHODOLOGY: Study Design: Prospective Observational study. Study Period: 2018-2019. Study Place: Institute of Child Health and Hospital for Children, Egmore. Study Population: Children in study age group admitted in ICH, satisfying the inclusion criteria. Inclusion Criteria: Children age 1 – 59 months. Case defined by the presence of respiratory signs and symptoms with evidence of pneumonia in chest radiography at admission in patients who had not been hospitalized within previous 30 days. Sample Size: 200 (based on 15% mortality from previous study). Exclusion Criteria: Hospital acquired pneumonia. · Prevalence of hypoxemia in my study of 200 patients is 10% as compared to 38% in a review study. · Prevalence of culture positive pneumonia was 8% as compared to other literate which had culture positive of 10%. · Prevalence of assisted ventilation which include invasive mechanical and non invasive ventilation was 40% as compared to 41% in other studies. This shows assisted ventilation is the independent risk factor for predicting mortality. · Prevalence of renal failure is 3.5%. Out of which 6 cases died with ARF with pneumonia - 85% mortality. · Prevalence of acute liver failure is 5%. Out of which 6 cases died with acute liver failure with pneumonia – 60% mortality. CONCLUSION: Thus I conclude that PIRO SCORE can be used as a tool to predict mortality of children hospitalised with community acquired pneumonia in a tertiary care institute. · Thus PIRO SCORE can be used as a tool to predict mortality and decision can be made on treatment strategies for intensive care admission and intensive management.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 201717006 |
| Uncontrolled Keywords: | Prognostic Scale, Predict, Mortality of Children Hospitalised, Community Acquired Pneumonia, Tertiary Care Hospital. |
| Subjects: | MEDICAL > Paediatrics |
| Depositing User: | Subramani R |
| Date Deposited: | 31 Jan 2021 15:07 |
| Last Modified: | 28 Feb 2021 14:40 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13538 |
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