Factors Related With Pneumonia among Children with Left-To- Right Shunt Congenital Heart Disease

Authors: Waworuntu D*

DOI: 10.23880/oajc-16000186

Volume 7, Issue 1

Abstract

Background: Infection is one of the major morbidities in congenital heart disease (CHD), especially pneumonia. Pneumonia in CHD has been known to increase overall morbidity and mortality. Early detection of pneumonia risk factors would help decrease the need for hospitalization, increase doctors’ awareness, and improve outcomes. Objective: To identify pneumonia’s incidence and risk factors in children with left-to-right shunt CHD. Method: This is a retrospective cohort study based on medical records of children aged 3 – 60 months hospitalized with diagnosis of any left-to-right shunt CHD with or without pneumonia in Cipto Mangunkusumo National Referral Hospital, Jakarta, in 2015-2019. Data of patients with CHD and pneumonia were retrieved from medical records based on ICD-10 codes. Patient’s clinical profiles were tested as possible risk factors for pneumonia: sex, age, birth weight, parental education, socioeconomic status, number of people in the house, nutritional status, type of heart defect, heart defect size, and immunization status. Bivariate analysis of parameters was done using the Chi square test. Parameters with a p-value less than 0.05 are included to multiple logistic regression test. Results: There were 333 subjects with left-to-right shunt CHD and 167 (50.2%) had pneumonia. The most common CHD type in pneumonia was ventricular septal defect (41.9%). The defect size was significantly related to pneumonia incidence (p=0.001). Risk factors identified to affect the occurrence of pneumonia in left-to-right shunt CHD were malnutrition [OR 5.152 (95% CI 2.363 – 11.234)], incomplete immunization [OR 9.689 (95% CI 4.322 – 21.721)], low socioeconomic status [OR 4.724 (95% CI 2.003 – 11.138)], and large defect [OR 5.463 (95% CI 1.949 – 15.307)]. Conclusion: The incidence of pneumonia in left-to-right shunt CHD was 50.2%, mostly in ventricular septal defects. Nutritional status, immunization status, socioeconomic status, and defect size were significant risk factors for pneumonia in children with left-to-right shunt CHD.

Keywords: Pneumonia; Congenital heart disease; Left-to-right shunt

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