| Objective:This study is based on a tertiary grade-A children’s specialist hospital in Shanxi Province medical record data,analyzed the types of diseases and age distribution of children in the hospital,understood the disease spectrum and age distribution of pediatric hospitalized children,and further explored the correlation between health-related behaviors and pediatric pneumonia through a 1:1 matched case-control study,so as to provide new ideas and scientific basis for the prevention of pediatric pneumonia.Methods:The medical records of hospitalized children from May to November 2020 in a tertiary grade-A children’s specialist hospital in Shanxi Province were selected,including clinical diagnosis and age,etc.SPSS22.0 software was used for descriptive statistical analysis of the clinical diagnosis and age of hospitalized children.A 1:1 matched case-control study was conducted.Children hospitalized with pneumonia at the age of 1to 3 years from May to November 2020 in a tertiary grade-A children’s specialist hospital in Shanxi Province were selected as the case group.Children hospitalized with surgery were selected as the control group according to the matching principle of admission in the same month and the age difference within 2 months.Univariate conditional Logistic regression was used to screen out the possible confounders,and further,Multivariate conditional Logistic stepwise forward regression method was used to adjust the confounders.P≤0.05 was used as inclusion criteria,and P≥0.10 was used as exclusion criteria.Theχ~2trend test was used to analyze whether there was a linear correlation trend between the outcome variable and the ordered multiple categorical variables,such as passive smoking,window ventilation,the frequency of hand washing,and the time of outdoor activities.Results:1.From May to November 2020,23,637 cases of hospitalized children were admitted to a tertiary grade-A children’s specialist hospital in Shanxi Province,among which,the number of hospitalized children due to pneumonia ranked first,with 1785cases.Preterm birth was the second cause of hospitalization of children,with 1,081 cases.The cases of upper respiratory tract infection,inguinal hernia and epilepsy all reached more than 800 cases,ranking third to fifth in the order of hospitalized diseases of children.The fifth to tenth hospitalized children were diarrhea,neonatal hyperbilirubinemia,neonatal pneumonia,craniocerebral injury,and febrile convulsion.2.The number of hospitalized children with pneumonia is highly concentrated in children aged 0 to 3 years.Among them,neonatal pneumonia ranks first,with a total of567 cases,and the number of hospitalized children aged 1-3 with pneumonia ranks second,with 557 cases.3.A total of 110 hospitalized children who met the requirements were enrolled in this case-control study.The mean age of the children in the case group was(21.47±6.62)months,and that of the children in the control group was(21.36±6.46)months.There were 69 male children and 41 female children in the case group,94 male children and 16female children in the control group.The residences of both the case group and the control group were mainly in towns,in which 80.9%of the children in the case group and 72.7%of the children in the control group lived in towns.4.The results of univariate Logistic regression analysis showed that there were statistically significant differences between the two groups in the 6 factors,including frequency of respiratory diseases(Waldχ~2=7.466,P=0.006),history of allergies(Waldχ~2=4.835,P=0.028),screen time over 2 hours per day(Waldχ~2=10.584,P=0.001),frequency of hand washing(Waldχ~2=5.865,P=0.015),outdoor activity time(Waldχ~2=7.138,P=0.008),and concentration on eating(Waldχ~2=6.287,P=0.012).5.Multivariate conditional Logistic stepwise forward regression analysis showed that more than 2 hours of screen time per day might be the risk factor for pediatric pneumonia,and outdoor activity time might be the protective factor for pediatric pneumonia.Among them,children with an average daily screen time of more than 2hours had a 2.529-fold increased risk of pediatric pneumonia compared with children with an average daily screen time of less than 2 hours(OR=3.529,95%CI:1.566～7.952,P=0.002).And compared with children whose average daily outdoor activity time was less than 30 minutes,children whose average daily outdoor activity time was between 30minutes and 1 hour reduced the risk of pediatric pneumonia by 75.8%(OR=0.242,95%CI:0.078～0.754,P=0.014),and children whose average daily outdoor activity time was between 1 and 2 hours reduced the risk of pediatric pneumonia by 83.7%(OR=0.163,95%CI:0.045～0.595,P=0.006),and children whose average daily outdoor activity time was more than 2 hours reduced the risk of pediatric pneumonia by 88.1%(OR=0.119,95%CI:0.027～0.522,P=0.005).6.The results showed that there may be a linear correlation trend between the frequency of hand washing and pneumonia in children(trendχ~2=5.818,P=0.016).Conclusion:1.The distribution of disease types of pediatric hospitalized children obtained in this study is consistent with the results of analysis in many places in China.Pneumonia ranks first among pediatric hospitalized diseases,and the prevention of pediatric pneumonia is still an important part in reducing the burden of pediatric diseases.2.The hospitalized children with pneumonia are highly concentrated in 0～3 years old,and attention should be paid to the prevention and treatment of pneumonia in children in this age group.3.Health-related behaviors are closely related to the occurrence of pneumonia in children.In the prevention and treatment of pneumonia in children aged 1-3 in the future,we can strengthen the propaganda to reasonably control the screen time and appropriately increase the time of outdoor activities,so as to achieve the purpose of preventing pneumonia in children. |
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