Time to Clinical Stability Among Pediatric Patients With Severe Pneumonia: Southwest Ethiopia: Prospective Follow-Up Study

Abstract

Background: Although clinical stability recognition was considered an early outcome in patients with pneumonia. Therefore, this study aimed to determine the time to clinical stability among pediatric patients with severe pneumonia in Southwest Ethiopia. Methods: A prospective follow-up study was conducted with 422 pediatric patients from June to November 2022 at a public hospitals. Data were analyzed using Epi-data and STATA, with the Kaplan-Meier survival estimate and Cox regression to assess time to stability and predictors. The proportional hazard model and Kaplan-Meier survival estimate graph were used to determine the time to clinical stability. Bivariate and multivariable Cox regression analysis were used to determine predictors of time to clinical stability. Results: In this study, children were followed for a total of 2718 person-days, with an incidence rate of 13.50% for clinical stability per 100 person-day observations. The median time to reach clinical stability was 5 days, and approximately 86.97% of pediatric patients with severe pneumonia achieved clinical stability. The most frequently observed abnormal parameter was elevated temperature, while lower oxygen saturation levels were associated with a longer time to clinical stability. Despite a thorough analysis, no statistically significant predictors were identified. Conclusion: In this study, most pediatric patients with severe pneumonia remained clinically stable throughout the follow-up period. The median time to clinical stability was 5 days, which was longer compared to other studies. Future research should focus on identifying predictors of delayed clinical stability using alternative analytical methods and larger sample sizes. Efforts should be made by stakeholders to reduce the time to clinical stability for pediatric patients.