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

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 two 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 1 s percent predicted (FEV₁ %), forced vital capacity percent predicted (FVC %), persistent cough, doctor diagnosis of asthma and abnormal chest shape.

Results: Cases were 2.9 times more likely (95% CI 1.45 to 5.71, p = 0.020) than controls to have persistent cough and 5.5 times more likely to have an abnormal chest shape (95% CI 1.65 to 18.28, p = 0.005). Cases of an atopic parent had a 7.0% deficit in FEV₁ % predicted (95% CI −10.5 to −3.2, p<0.001) and a 4.4% deficit in FVC % predicted (95% CI −8.0 to −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 to 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.