Risk factors for fatal pneumonia: a case control study.

We conducted a case control study to identify the risk factors for death among hospitalized children with acute pneumonia at the Institute of Child Health, Madras. All the 70 patients who died of pneumonia constituted the case--patients and 140 children recovered from pneumonia, selected by systematic sampling, during the same period served as controls. By univariate analysis, the risk factors for death in pneumonia observed were associated illnesses--Odds Ratio (OR) 22.2. (95% confidence interval [CI] 9.8-51.4; p = < 0.001); congenital anomalies--OR 10.4 (2.9-37.8; p = < 0.001); severe pneumonia--OR 4.2 (1.2-14.4; p = 0.09); marasmic status--OR 2.9 (1.5-5.7; p = 0.001); age under 6 months--OR 2.8 (1.3-5.7; p = 0.004); and severity of the pneumonia (lobar versus segmental)--OR 2.0 (0.9-4.5; p = 0.09). By logistic regression analysis the following risk factors were significant--associated illnesses. (51.6; 18-146.9; p = < 0.001); age under 6 months (6.5; 2-20.6; p = < 0.001), marasmic status (5.8; 2.2-15.6; p = < 0.001); and congenital anomalies (3.8; 2.0-7.1; p = < 0.001). These risk factors should be kept in mind by the clinicians for appropriate intervention at an earlier stage to minimize death.