Examining the clinical, radiological and microbiological features of children with complicated pneumonia who were hospitalized in Hacettepe University İhsan Doğramaci Children's Hospital in the last 10 years and determining the prognostic factors

In our hospital, as seen in the literature in recent years, the frequency of complicated pneumonia (pneumonia accompanied by conditions such as parapneumonic pleural effusion, empyema, necrotizing pneumonia, lung abscess) has increased and this is the reason for increased morbidity and mortality in children. This study aims to examine the demographic and clinical features of pediatric patients who have developed complicated pneumonia and treated in the last decade; identifying variables that may be associated with complicated pneumonia; and aims to determine the prognosis of the disease, clinical and laboratory parameters that can be used to estimate the length of hospital stay. In our study 204 patients had at least one complication (160 (%48) parapneumonic effusion, 56 (%18) atelectasis, 37 (%12) necrotizing pneumonia, 36 (%12) empyema, 19 (%6) lung abscess, 14 (%4) pneumothorax), 99 patients were treated with the diagnosis of pneumonia without any complications. When we compare complicated pneumoniae with noncomplicated group there was no statistically significant difference about average age, female/male gender ratio, premature birth history, average breastfeeding time, school / daycare center attendance status, influenza vaccine status, tobacco exposure at home, number of febrile days and use of oral antibiotics before admission to hospital. Patients with complicated pneumonia have lower rate of vaccination with pneumococcal vaccine, longer symptom duration and lower fever before hospital admission, higher ibuprofen use rate, higher chest pain at admission, higher malnutrition rate, higher rate of anemia, trombocytosis, hypoalbuminemia, higher erythrocyte sedimentation rate and higher serum C-reactive protein level. In order to determine prognostic factors in patients with complicated pneumonia, the duration of hospitalization, the defervescence time after the initiation of antibiotic therapy, pleural fluid drainage time and recovery time of radiological findings were investigated as outcome parameters. Premature birth history, duration of breastfeeding, going to school /daycare center, influenza vaccine status, tobacco exposure at home and oral antibiotic use before admission did not affect the outcome variables in complicated pneumonia patients. Ibuprofen use before admission to hospital, malnutrition, anemia, trombocytosis, hypoalbuminemia, hyponatremia, high serum CRP level and detection of microorganism and pneumococci DNA in plevral fluid, high plevral fluid LDH level and low plevral fluid glucose level were determined as factors affecting the outcome parameters and prolonging healing time.