Community-acquired pneumonia hospitalization among children with neurologic disorders

Alexander J. Millman, Lyn Finelli, Anna M. Bramley, Georgina Peacock, Derek J. Williams, Sandra Arnold, Carlos G. Grijalva, Evan J. Anderson, Jonathan Mccullers, Krow Ampofo, Andrew T. Pavia, Kathryn M. Edwards, Seema Jain

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7 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)188-195.e4
JournalJournal of Pediatrics
Volume173
DOIs
StatePublished - Jun 1 2016

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Nervous System Diseases
Pneumonia
Hospitalization
Intensive Care Units
Hospitalized Child
Cerebral Palsy
Down Syndrome
Chromosome Aberrations
Epilepsy
Spinal Cord
Epidemiology
Multivariate Analysis
Logistic Models
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Millman, A. J., Finelli, L., Bramley, A. M., Peacock, G., Williams, D. J., Arnold, S., ... Jain, S. (2016). Community-acquired pneumonia hospitalization among children with neurologic disorders. Journal of Pediatrics, 173, 188-195.e4. https://doi.org/10.1016/j.jpeds.2016.02.049

Community-acquired pneumonia hospitalization among children with neurologic disorders. / Millman, Alexander J.; Finelli, Lyn; Bramley, Anna M.; Peacock, Georgina; Williams, Derek J.; Arnold, Sandra; Grijalva, Carlos G.; Anderson, Evan J.; Mccullers, Jonathan; Ampofo, Krow; Pavia, Andrew T.; Edwards, Kathryn M.; Jain, Seema.

In: Journal of Pediatrics, Vol. 173, 01.06.2016, p. 188-195.e4.

Research output: Contribution to journalArticle

Millman, AJ, Finelli, L, Bramley, AM, Peacock, G, Williams, DJ, Arnold, S, Grijalva, CG, Anderson, EJ, Mccullers, J, Ampofo, K, Pavia, AT, Edwards, KM & Jain, S 2016, 'Community-acquired pneumonia hospitalization among children with neurologic disorders', Journal of Pediatrics, vol. 173, pp. 188-195.e4. https://doi.org/10.1016/j.jpeds.2016.02.049
Millman, Alexander J. ; Finelli, Lyn ; Bramley, Anna M. ; Peacock, Georgina ; Williams, Derek J. ; Arnold, Sandra ; Grijalva, Carlos G. ; Anderson, Evan J. ; Mccullers, Jonathan ; Ampofo, Krow ; Pavia, Andrew T. ; Edwards, Kathryn M. ; Jain, Seema. / Community-acquired pneumonia hospitalization among children with neurologic disorders. In: Journal of Pediatrics. 2016 ; Vol. 173. pp. 188-195.e4.
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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.",
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AU - Millman, Alexander J.

AU - Finelli, Lyn

AU - Bramley, Anna M.

AU - Peacock, Georgina

AU - Williams, Derek J.

AU - Arnold, Sandra

AU - Grijalva, Carlos G.

AU - Anderson, Evan J.

AU - Mccullers, Jonathan

AU - Ampofo, Krow

AU - Pavia, Andrew T.

AU - Edwards, Kathryn M.

AU - Jain, Seema

PY - 2016/6/1

Y1 - 2016/6/1

N2 - 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.

AB - 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.

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U2 - 10.1016/j.jpeds.2016.02.049

DO - 10.1016/j.jpeds.2016.02.049

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