Keywords: Community-acquired pneumonia; liver injury; children; mortality; hospital length of stay.

Abstract

Background: The present study was undertaken to evaluate the association between liver injury and clinical parameters, outcomes and length of stay (LOS) in hospital in children with community-acquired pneumonia (CAP).

Methods: Clinical data and laboratory indicators of 2,573 children with CAP were analyzed. The association between liver injury and clinical parameters, outcomes and LOS was then analyzed.

Results: Higher liver injury class was associated with higher incidence of severe CAP, comorbidities, hypoxia, requirement for mechanical ventilation, 30-day mortality and intensive care unit admission, and higher indicators of inflammation (C-reactive protein, procalcitonin and white blood cell count), longer LOS, faster respiratory rate and pulse rate, and lower age, serum albumin levels, monocyte and lymphocyte counts. Severe liver injury was identified as an independent factor for 30-day mortality and prolonged LOS in children with CAP. Higher liver injury class was associated with a lower cumulative survival rate (p=0.0004), and log-rank test for trend was used to demonstrate the association of each injury class with 30-day mortality (p=0.0002).

Conclusions: Several parameters were associated with liver injury in children with CAP. Severe liver injury was found to be an independent factor for 30-day mortality and LOS in children with CAP.

Keywords: Community-acquired pneumonia; liver injury; children; mortality; hospital length of stay.

A.    AFRICAN HEALTH SCIENCES OPEN ACCESS POLICY

While African Health Sciences has been freely accessible online there have been questions on whether it is Open Access or not. We wish to clearly state that indeed African Health Sciences is Open Access. There are key issues regarding Open Access needing clarification for avoidance of doubt:

1.      Henceforth, papers in African Health Sciences will be published under the CC BY (Creative Commons Attribution License) 4.0 International. See details on https://creativecomons.org/)2.      The copyright owners or the authors grant the 3rd party (perpetually and in advance) the right to disseminate, reproduce, or use the research papers in part or in full, format/medium as long as:No substantive errors are introduced in the processAttribution of authorship and correct citation details are givenThe referencing details are not changed.

Should the papers be reproduced in part, this must be clearly stated.

3.      The papers will be freely and universally accessible online in an easily readable format such as XML in at least one widely recognized open access repository such as PUBMED CENTRAL.

B. ABRIDGED LICENCE AGREEMENT BETWEEN AUTHORS AND African Health Sciences

I submitted my manuscript to African Health Sciences and would like to affirm that:

1.0  I am authorized by my co-authors to enter into these arrangements.

2.0 I guarantee, on behalf of self and co-authors:

That the paper is original, and has not been published in any other peer-reviewed journal; nor is it under consideration by other journal (s). It does not infringe existing copyright or any other person’s rights

 

That we are/I am the sole author(s) of the paper and with authority to enter into this agreement. My granting rights to African Health Sciences is not in breach of any other obligation

 

That the paper contains nothing unlawful, or libelous. Nor anything that would constitute a breach of contract, confidence or commitment given to secrecy, if published

 

That I/we have taken care to ensure the integrity of the article.

3.0  I and all co-authors, agree that the paper, if accepted for publication, shall be licensed under the Creative Commons Attribution License 4.0. (see https://creativecommons.org/)