Academic journal article Central European Journal of Public Health

Trends in Hospitalization of Children with Bacterial Pneumonia in Poland

Academic journal article Central European Journal of Public Health

Trends in Hospitalization of Children with Bacterial Pneumonia in Poland

Article excerpt

INTRODUCTION

The inflammations of the lower respiratory tract are regarded as the main cause of morbidity and mortality of children (1-3). Community-acquired pneumonia is the leading cause of hospitalization in children's wards both in developed and developing countries (4, 5).

There are many aetiologic factors that cause pneumonia, such as Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Legionella pneumophila as well as Gram negative bacilli. Many studies show that S. pneumoniae is the most frequent pathogen of invasive bacterial infections of children and it is responsible for the majority of cases of pneumonia in this age group (4, 6). A serious course of the disease often requires hospitalization (7, 8). As evidenced by research, the most invasive infections concern babies under 2 years of age (9, 10). The infections caused by S. pneumoniae are regarded as infections with a high mortality. According to the estimates of the World Health Organization (WHO), this bacteria causes 12% of deaths of children under the age of 5 in the European region (11).

Due to its high health and life risk, according to the recommendations of the British Thoracic Society, Pediatric Infectious Diseases Society and Infectious Diseases Society of America, bacterial pneumonia of babies under 3 months of age is usually treated in hospital conditions. Also older children are frequently hospitalized, especially when suffering from immunosuppression, tachypnea, dyspnea, fever, dehydration symptoms, vomiting, general severe condition with toxic and septic symptoms as well as neurological symptoms (disorders of consciousness, convulsions). Hospital admission is also recommended in case of lack of health improvement after 3 days of treating pneumonia at home, disease regression or complication, and also for reasons of social nature (12).

The purpose of the present study was to assess the hospitalization trends in children aged 0-6 suffering from pneumonia with bacterial aetiology in the years 2007-2011 in Poland.

MATERIALS AND METHODS

The data on the hospitalized patients in Poland in the years 2007-2011 were collected from the nation-wide database stored in the National Institute of Public Health - National Institute of Hygiene in Warsaw. This database contains information collected within the framework of the Statistical Research of Public Statistics Programme, which covers almost all hospitalized cases (ie. 98% of hospitals in Poland send monthly data to the database, which accounts for approximately 7 million records annually). The statistical research programme is annually approved by the Prime Minister, and each hospital has a statutory reporting obligation in this regard. Data regarding incidence of bacterial pneumonia are presented according to the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10, valid since 1997). In hospitals, codes based on diagnosis established by the doctor and recorded in the patient's medical records are given by the hospital statistical unit. The collected data from general hospitals cover the period from 2007-2011.

The study analyzed the data pertaining to children aged 0-6, qualified on the grounds of date of birth (date of hospital discharge - date of birth). For all the investigated children the major cause of hospitalization was pneumonia. According to the ICD-10, we collected the data on patients hospitalized because of bacterial pneumonia (i.e. S. pneumoniae (J13), H. influenzae (J14) and bacterial pneumonia, not classified elsewhere (J15)). In the further part of the present study, the term of pneumonia is used for this group of diseases.

The analysis took into account age, gender, domicile (city or country), and length of stay (LOS) in hospital. The estimation of frequency of occurrence of pneumonia was calculated on the basis of the hospitalization rate (the number of children hospitalized per year in relation to the analyzed population). …

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