Risk Factors For Invasive Mechanical Ventilation In Children With Pertussis-Associated Severe Pneumonia

Objective:To investigate and analyze the relevant risk factors for invasive mechanical ventilation in children with pertussis-associated severe pneumonia.Methods:A retrospective study of children with pertussis-associated severe pneumonia was performed in 65 cases that with invasive mechanical ventilation(case group)and 175 cases not with invasive mechanical ventilation(control group)in Children’s hospital of Chongqing Medical University from January 2015 to December 2019.Their clinical characteristics were summarized.Variables that were significantly different between the two groups in univariate analysis were analyzed by multivariate logistic regression models,and receiver operating characteristic(ROC)curve analysis was performed to find out the cut-off value for the significant relevant factors.Results:Four factors were independently associated with increased risk for invasive mechanical ventilation,which were age(OR 0.847,95%CI0.721～0.994)、development of cardiovascular complications(OR 4.169,95%CI 1.344～12.934)、atelectasis(OR 3.978,95%CI 1.067～14.824)、WBC count(OR 1.080,95%CI 1.042-1.120).It was found that WBC>23.34×10~9/L was of high value in predicting use of invasive mechanical ventilation.The predicted sensitivity and specificity were 0.600and 0.829,respectively,and the corresponding AUC=0.701.Conclusions:Children with pertussis-associated severe pneumonia who have a higher WBC count(especially more than 23.34×10~9/L),a younger age and with cardiovascular complications or atelectasis are more likely to need invasive mechanical ventilation.