Results
Of the 91 children, 53 (58.2%) had non-severe pneumonia and 38 (41.8%) had severe pneumonia. The mean age was 3.8 ± 2.9 years, and males constituted 56.0% of the study population. Children younger than one year were significantly more frequent among severe cases than non-severe cases (23.7% vs. 11.3%, P=0.041). Tachypnea, respiratory distress, chest indrawing, nasal flaring, grunting, hypoxemia, and oxygen requirement were significantly more frequent among children with severe pneumonia (P<0.05 for all). Mean WBC and neutrophil counts were significantly higher in severe cases (17.2 ± 6.8 vs. 13.8 ± 5.1 ×10⁹/L, P=0.008; and 11.6 ± 5.8 vs. 8.5 ± 4.3 ×10⁹/L, P=0.005, respectively). Median CRP and procalcitonin levels were also significantly higher in severe pneumonia (101 vs. 39 mg/L and 1.43 vs. 0.35 ng/mL, respectively; P<0.001 for both). In multivariable analysis, hypoxemia was the strongest independent predictor of severe pneumonia (adjusted OR=7.82, 95% CI: 2.75–22.24; P<0.001), followed by tachypnea (OR=5.16, 95% CI: 1.42–18.71; P=0.013) and chest indrawing (OR=4.37, 95% CI: 1.61–11.88; P=0.004). CRP >60 mg/L and procalcitonin >0.5 ng/mL were also independently associated with severe disease. ROC analysis demonstrated that procalcitonin had the highest discriminatory ability (AUC=0.821), followed by CRP (AUC=0.789) and WBC count (AUC=0.681). Severe pneumonia was associated with higher rates of ICU admission, respiratory failure, sepsis, oxygen requirement, and prolonged hospitalization.
