Table of Contents

HK J Paediatr (New Series)
Vol 29. No. 4, 2024

HK J Paediatr (New Series) 2024;29:212-224

Original Article

Risk Factors for Myocardial Damage and Its Effects on the Prognosis of Children with Severe Pneumonia: A Cross-sectional Study

Y Mei, D Tang, L Zhao, M Peng, B Zhu


Abstract

Background: Severe pneumonia is a common paediatric respiratory infection that progresses rapidly and can lead to various complications. Heart failure as a complication of severe pneumonia is one of the important causes of death in children. Heart failure primarily occurs due to myocardial damage. The present study aimed to investigate the risk factors of myocardial damage in children with severe pneumonia and its influence on their prognosis to provide a reference for the early prevention, diagnosis, and treatment of myocardial damage. Methods: A total of 408 children with severe pneumonia from May 2020 to August 2022 were retrospectively analysed and assigned to two groups according to whether they had concomitant myocardial damage. The general data questionnaire designed by the researcher was used to collect the general characteristics of the included children. The relationship between clinical features and myocardial damage in children with severe pneumonia was analysed by t-test and chi-square test. Binary and multiple linear regression analyses were performed to determine the independent risk factors of myocardial damage and poor prognosis in children. Results: Of the included 408 children with severe pneumonia, 50 (12.3%) had a complication of myocardial injury. Binary logistic regression analysis showed that low age (odds ratio [OR] =0.879, P=0.041), concomitant hypoxaemia (OR=4.433, P=0.002), concomitant hypokalaemia (OR=4.548, P=0.001), concomitant hypoproteinaemia (OR=4.047, P=0.019), concomitant respiratory failure (OR=3.506, P=0.016), decreased pH (OR=0.000, P=0.002), decreased PaO2 (OR=0.922, P=0.007), decreased HCO3- concentration (OR=0.820, P=0.037), increased procalcitonin (OR=2.415, P=0.007), increased C-reactive protein (OR=1.083, P=0.016), elevated vascular endothelial growth factor (OR=1.544, P=0.012), and elevated cystatin C (CysC) (OR=1.737, P=0.039) were independent risk factors for concomitant myocardial damage in children with severe pneumonia. Multiple linear regression analysis also showed that concomitant myocardial damage (P=0.045) was an independent risk factor for the prognosis of children with severe pneumonia. Conclusion: The incidence of myocardial damage in children with severe pneumonia is still high, and it severely affects the prognosis of children. Clinicians should give utmost attention to the clinical characteristics and related serological markers of patients, identify relevant risk factors as early as possible, and actively implement corresponding therapeutic measures to reduce the incidence of myocardial damage in children.

Keyword : Children; Myocardial damage; Retrospective study; Severe pneumonia


 
 

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