Study On Clinical Features And Risk Factors Of Hospitalized Children With Pulmonary Hemorrhage

Objective:To investigate the clinical characteristics,etiological composition and risk factors of death in hospitalizated in children with pulmonary hemorrhage.Methods:A retrospective study of patients with pulmonary hemorrhage admitted to Shenzhen Children’s Hospital from February 2013 to October 2019 was conducted.We differentiated patients into critical group and non-critical group according to whether they were admitted to the ICU or not.And compare the clinical features between the groups.Logistic regression was conducted for risk factors assessment.Results:1.A total of 133 children with pulmonary hemorrhage were included.Among 133 cases,72 were male and 61 were female,with a median age of 3.6 years.The clinical feactures are cough(102,76.7%),hemoptysis(77,57.9%),fever(68,51.1%),dyspnea(50,37.6%)and tachypnea(60,45.1%).The imaging findings were mainly involving invasive multi-lobe density increased shadow.2.The etiology of pulmonary hemorrhage were infectious diseases(61,45.9%),cardiovascular diseases(27,20.3%),hematological diseases(14,10.5%),idiopathic pulmonary hemosiderosis(14,10.5%),immunological diseases(8,6.0%),and others(9,6.8%).3.Compared with the non-critical group,the critical group was younger,were more likely to have fever,dyspnea,tachypnea,rales,hepatomegaly,splenomegaly and color change in skin.while the non-critical group were more likely to have hemoptysis and cough.RBC,PLT and Hb of critical group were lower than non-critical group,while CRP was higher than non-critical group(P<0.05).4.39 patients died,the total mortality was 29.3%.Younger than 2 years old,shock and PLT less than 50*10~9/L were independent risk factor for pulmonary hemorrhage mortality.Conclusion:1.Pulmonary hemorrhage is a life-threatening disease in pediatric ward.The overall mortality rate is high.The younger the age,the more serious the disease.2.The clinical features of pulmonary hemorrhage in children are lack of specificity.The common aetiological factor is infectious disease.3.Younger than 2 years old,shock and PLT less than 50*10~9/L were independent risk factor for pulmonary hemorrhage mortality.Clinicians should pay special attention to young children with low PLT,and actively prevent and manage shock to reduce the case fatality rate.