A follow-up study of children hospitalised with community acquired pneumonia

Katherine M Eastham ¹, Donna Hammal ², Louise Parker ² and David Spencer ^3*

¹ Royal Victoria Infirmary, United Kingdom
² School of Clinical Medical Sciences (Child Health), University of Newcastle upon Tyne, United Kingdom
³ Freeman Hospital, United Kingdom

^* To whom correspondence should be addressed. E-mail: david.spencer2{at}nuth.nhs.uk.

Accepted 6 March 2008

Abstract

Objective: To investigate the outcome for children hospitalised with radiologically confirmed community acquired pneumonia (CAP)

Design: Controlled Follow-up Study Setting: Community based in Newcastle upon Tyne, North Tyneside and Northumberland schools

Patients: 103 cases of radiologically confirmed CAP a median of 5.6 years (range 4.4-7.4) after admission to Newcastle General Hospital, matched for sex and school class to a mean of 2 controls (n = 248)

Interventions: A respiratory questionnaire, clinical examination and spirometry measurements. Main Outcome Measures: Multiple regression was used to describe associations between explanatory variables, including CAP, and outcome variables: forced expiratory volume in one second percent predicted (FEV1%), forced vital capacity in one second percent predicted (FVC%), persistent cough, doctor diagnosis of asthma and abnormal chest shape.

Results: Cases were 2.4 times more likely (95% CI: 1.02, 5.77, p=0.046) to have persistent cough and 5.5. more likely to have an abnormal chest shape (95% CI: 1.65, 18.28, p=0.005). Cases of an atopic parent had a 7.0% deficit in FEV1% (95% CI: -10.5, -3.2, p<0.001) and a 4.4% deficit in FVC% (95% CI: -8.0, -0.78, p=0.017) but were not at increased risk of subsequent asthma. Cases of a non-atopic parent were at increased risk of subsequent asthma (OR 4.8, 95% CI: 1.43, 16.34, p=0.011) but not of deficit in lung function.

Conclusions: CAP requiring admission to hospital is associated with deficits in lung function and persistent respiratory symptoms. This has implications for follow-up for which recommendations are currently lacking. Parental atopy may be a determinant of outcome.