Clinical Profile, Management, and Outcomes of Pediatric Pneumonia Patients Admitted to the Intensive Care Unit: A Retrospective Cohort Study

Abstract

Geographical and socioeconomic factors affect the incidence and outcomes of pneumonia, which is a major cause of severe illness and mortality in children globally.  There is a dearth of information on the characteristics and consequences of severe pediatric pneumonia in Libya, a growing upper-middle-income nation with a healthcare system with limited resources.  The purpose of this study was to describe the clinical characteristics, course of treatment, and results of pediatric pneumonia patients hospitalized to an intensive care unit (ICU) in Libya. 139 consecutive pediatric patients (age ≤18 years) hospitalized to the intensive care unit at Zawia Medical Center between January and December 2023 were the subject of a retrospective cohort study.  Patients were split into two groups: those with pneumonia (n = 48) and those without (n = 91).  Study variables focused on the outcomes, clinical course, and demographics.  The main "severe outcomes" for the patients in this study were demand for mechanical ventilation or fatality. The cohort's median age was 24 months (IQR: 0-88).  For 48 patients (34.5%), pneumonia was the main reason for admission.  Patients with pneumonia exhibited a clear seasonal peak in the winter and were substantially younger than those without pneumonia (median age, 12.6 vs. 85.7 months, p < 0.001).  The pneumonia group required more mechanical ventilation (25% vs. 6.6%, p = 0.004) and had a significantly higher mortality rate (20.8% vs. 6.6%, p = 0.012). younger age was the most significant risk factor for mortality, with an average age of 12.6 months vs. 85.7 months for mortalities and survival cases, respectively (p = 0.012). The presence of comorbidities (65.2% vs. 32.0%, p = 0.02) and a positive C-reactive protein (CRP) level> 30 mg/L were substantially linked to the pneumonia group, with worsening (p = 0.01). Pediatric pneumonia results in severe morbidity and high mortality and is a significant cause of ICU admission.  Important risk factors for poor outcomes include younger age, elevated CRP, and underlying comorbidities. To improve patient treatment and inform national standards, these findings emphasize the need for further multicenter research, protocolized management, and improved seasonal planning.