Hypoxaemia as a measure of disease severity in young hospitalised Nigerian children with pneumonia: A cross-sectional study
Background: Pneumonia remains a common cause of mortality among children in developing countries. Hypoxaemia is a common consequence of pneumonia in children.
Objectives: To define the relationship between Hb oxygen saturation (SpO2) and parameters of outcome, duration of supplemental oxygen and duration of hospitalisation among children with pneumonia.
Methods: A cross-sectional study was carried out at the paediatric wards of a tertiary hospital in North-Central Nigeria. Two hundred children aged between 2 and 59 months with pneumonia seen at the University of Ilorin Teaching Hospital were recruited consecutively. Sociodemographic and clinical information regarding the illness was obtained. Hb SpO2 of subjects was recorded with a pulse oximeter at presentation. The primary outcome was the SpO2 of the children with pneumonia. Secondary outcome measures were disease outcome, duration of supplemental oxygen and duration of hospitalisation among children with pneumonia.
Results: The prevalence of hypoxaemia among the children was 41.5% and their mean SpO2 was 90.4% (standard deviation (SD) 8.9%). Surviving children with hypoxaemia had a longer mean (SD) duration of hospitalisation of 6.9 (6.4) days compared with those without hypoxaemia (4.9 (2.7) days; p=0.001). Children with hypoxaemia spent a longer duration receiving supplemental oxygen compared with those without hypoxaemia (p=0.001). The case fatality rate from pneumonia was 8.5% (17 deaths). The risk of death among children with hypoxaemia was 48 times higher than among the non-hypoxaemic children.
Conclusion: Hypoxaemia with increasing severity significantly predicts a longer duration of hospitalisation, duration on supplemental oxygen and poorer outcome in children with pneumonia.