Predictive value of hematological indices in community acquired pneumonia in children: A prospective observational study

Abstract

Introduction: Community acquired pneumonia is an important cause of morbidity and mortality in the pediatric population, especially in the under-5 age group. It is essential to identify parameters for early diagnosis and prognostication. Conventionally used markers such as CRP and procalcitonin are expensive and often unavailable in low-resource settings. This mandates the use of novel and ubiquitous investigations such as complete hemogram. The present study aimed at evaluating the role of novel systemic inflammatory indices (NLR, MLR, PLR, SII, SIRI) in predicting disease severity in children with community acquired pneumonia.

Methods: This prospective observational study, conducted at a tertiary care center of North India, included 130 children aged 1 month–14 years admitted to the Paediatrics ward with a diagnosis of community acquired pneumonia. The relevant clinical features and complete hemogram of the child were recorded and defined indices calculated. The role of these indices in predicting the need for ICU admission, vasopressor use, and development of complications including mortality was evaluated using ROC curves.

Results: NLR was found to have the highest sensitivity in predicting disease severity. It could predict the need for ICU admission with a sensitivity of 78.5% and specificity of 50% (p=0.0174). It might be an important marker in predicting mortality in children with community acquired pneumonia. MLR also demonstrated high specificity in predicting complications.

Conclusion: NLR derived from routine hemogram can be used as a simple and non-expensive screening tool for predicting the development of severe illness and complications in children hospitalized with community acquired pneumonia.