Lethality by pneumonia and factors associated to death

Objective to describe the case-fatality rate (cfr) and risk factors of death in children with community-acquired acute pneumonia (cap) in a pediatric university hospital. method a longitudinal study was developed with prospective data collected from 1996 to 2011. patients aged 1 month to 12 years were included in the study. those who left the hospital against medical orders and those transferred to icu or other units were excluded. demographic and clinical-etiological characteristics and the initial treatment were studied. variables associated to death were determined by bivariate and multivariate analysis using logistic regression. results a total of 871 patients were selected,of whom 11 were excluded; thus 860 children were included in the study. there were 26 deaths,with a cfr of 3%; in 58.7% of these,penicillin g was the initial treatment. pneumococcus was the most common pathogen (50.4%). from 1996 to 2000,there were 24 deaths (93%),with a cfr of 5.8% (24/413). from 2001 to 2011,the age group of hospitalized patients was older (p = 0.03),and the number of deaths (p = 0.02) and the percentage of disease severity were lower (p = 0.06). only disease severity remained associated to death in the multivariate analysis (or = 3.2; 95%ci: 1.2-8.9; p = 0.02). conclusion when the 1996-2000 and 2001-2011 periods were compared,a significant reduction in cfr was observed in the latter,as well as a change in the clinical profile of the pediatric inpatients at the institute. these findings may be related to the improvement in the socio-economical status of the population. penicillin use did not influence cfr. © 2013 sociedade brasileira de pediatria.