Pediatrics · Infectious Disease · 1 h ago
Respiratory Infections in Children Eligible for Palliative Care: Risk Factors for Support Escalation
A single-center retrospective study in Bologna examined respiratory-infection admissions among children eligible for pediatric palliative care. Higher clinical-complexity scores and elevated C-reactive protein were independently associated with escalation of respiratory support.
- Lower respiratory infections made up 86.3% of admissions.
- Respiratory support was escalated in 76.9% of admissions.
- High ACCAPED score and CRP predicted escalation.
- Single-center retrospective findings need broader validation.
Researchers retrospectively reviewed hospitalizations for respiratory infections from January 2019 to February 2025 at a tertiary hospital in Bologna, Italy. The cohort comprised nononcologic children eligible for pediatric palliative care with an ACCAPED score of at least 30. Among 319 eligible patients, 99 had at least one infectious hospitalization; the study reports 117 respiratory-infection admissions involving 56 children.
Lower respiratory tract infections accounted for 86.3% of admissions, and viruses were identified in most cases. Respiratory support was escalated in 76.9% of admissions; 6% required pediatric intensive care, and mortality was 1.7%. Pseudomonas aeruginosa was the most frequently isolated bacterial pathogen, particularly among children with tracheostomies. An ACCAPED score of at least 75 (OR 2.43, 95% CI 1.04–5.68) and C-reactive protein of at least 8 mg/dL (OR 3.85, 95% CI 1.48–10.00) were independently associated with support escalation.
The findings identify potential markers for risk assessment in this medically complex population. However, the retrospective study was conducted at one center, and support escalation was used as a proxy for worsening outcome; the results do not establish that acting on these markers improves outcomes.
In practice
For children eligible for pediatric palliative care who are hospitalized with respiratory infections, this single-center cohort found that an ACCAPED score of at least 75 and C-reactive protein of at least 8 mg/dL were independently associated with escalation of respiratory support. These measures may help identify patients at higher risk in this setting, but the retrospective findings do not show that marker-based monitoring or intervention improves outcomes. The study’s single-center design and use of support escalation as a proxy limit generalizability.
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The Pediatric Infectious Disease Journal: Respiratory Infections in Patients Eligible for Pediatric Palliative Care ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.