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ICU admittance more common among children with neurologic disorders, CAP
A study published in The Journal of Pediatrics reported that children with neurologic disorders and hospitalized with community-acquired pneumonia were more likely to be admitted to the ICU than children without these disorders.
“Our results highlight that children with neurologic disorders are vulnerable to severe illness when hospitalized with [community-acquired pneumonia (CAP)],” Alexander J Millman, MD, in the influenza division of the Epidemic Intelligence Service, told Healio.com/Pediatrics.
Alexander J Millman
Children with neurologic disorders are at increased risk for complications and death from influenza and respiratory syncytial virus infection, the researchers wrote. However, there is limited data describing CAP in children with neurologic disorders.
As part of the CDC’s Etiology of Pneumonia in the Community (EPIC) prospective study, Millman and colleagues, including Kathryn M. Edwards, MD, of Vanderbilt University and an Infectious Diseases in Children Editorial Board member, assessed 2,358 children with radiographically confirmed CAP. All were enrolled between 2010 and 2012 at three hospitals in the United States. Neurologic disorders included cerebral palsy, developmental delay, Down syndrome, epilepsy, non-Down syndrome chromosomal abnormalities and spinal cord abnormalities. The researchers compared epidemiology, etiology, and clinical outcomes in children with neurologic disorders (11.9%), non-neurologic underlying conditions (39.6%), or no underlying conditions (48.5%).
The researchers wrote that children with neurologic disorders were older (median age, 4.2 years) and more likely to be admitted to the ICU (36.4%) than children with non-neurologic underlying conditions (median age, 2.7 years; 19.8%) and those with no underlying conditions (median age, 1.8 years; 18.4%). Using age-stratified analysis, the researchers found that children with neurologic disorders were less likely to have a pathogen detected than children with non-neurologic underlying conditions.
The children with neurologic disorders also were more likely to have coexisting congenital heart disease (30.4%) and chronic lung disease (12.5%).
“Given these findings, it is critical that children with neurologic disorders receive recommended immunizations,” Millman said. “If children with neurologic disorders are hospitalized with CAP, they may require extra attention, and it is important that they receive appropriate respiratory care.” – by Will Offit
Disclosure: The researchers report no relevant financial disclosures.
