EVALUATION OF BIOMARKERS TO PREDICT OUTCOMES AMONG CHILDREN HOSPITALIZED WITH SEVERE COMMUNITY ACQUIRED PNEUMONIA IN WEST NUSA TENGGARA PROVINCE GENERAL HOSPITAL, INDONESIA

Sang Ayu Kompiyang Indriyani1, Diah Asri Wulandari2 and Cissy Rachiana Kartasasmita2

Abstract

Community Acquired Pneumonia (CAP) is a leading cause of respiratory morbidity and mortality among children aged <5 years. In this study, we aimed to evaluate biomarkers associated with outcomes in severe CAP cases in order to guide management of these cases. Study subjects were children aged 1-59 months hospitalized with severe CAP during January to October 2018. The study was performed prospectively at West Nusa Tenggara Province General Hospital in Mataram, Indonesia. Inclusion criteria for study subjects were being of study age hospitalized at the study institution during the study period with severe CAP. The exclusion criterion for study subjects was having one or more comorbidities that could significantly affect the variables studied. We recorded the following on admission: c-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), leukocyte count (LC) and neutrophil-to-lymphocyte ratio (NLR). Patient outcomes (duration of oxygen use, length of hospital stay, death) and demographic characteristics were also recorded. A total of 90 subjects were included in the study, 59% male. The median subject age was 7 months. Our results showed none of the biomarkers were associated with duration of oxygen use or length of hospital stay. Only one factor was significantly associated with outcome: for every log increase in ESR, the age-adjusted log odds of dying due to severe CAP decreased by 3.3 (p = 0.043). Children aged <59 months admitted to the study hospital with a diagnosis of severe CAP who have a low ESR should be monitored more carefully and treated more aggressively due to their higher odds of dying from severe CAP.