Background: Pneumonia remains to be a leading cause of death in children. The RDW would be very useful and cost-efficient if proven to have clinical validity in predicting outcomes of pneumonia in children.
Methodology: This is a retrospective cohort study of children ages 1-18 who were admitted at PHC from January 1, 2013 to December 31, 2015 with a diagnosis of pneumonia. Demographic data, laboratory and clinical parameters such as, RDW, WBC and presence of tachypnea, adventitious lung sounds, or chest in-drawing were recorded and analyzed in relation to clinical outcome.
Results: There are 59 (50%) females and 57 (49.1%) males. The coexisting illnesses identified were congenital heart disease (37, 31.9%), bronchial asthma (15, 12.9%), and rheumatic heart disease (7, 6%). Most (84, 72.4%) of the patients were diagnosed with PCAP C. The mean RDW was 14.57 (SD 2.40) while the mean WBC was 11.60 (SD 5.25). There is a significant association between abnormal RDW and development of complications (p<0.001) as well as non-survival (p<0.006) from pneumonia. Elevated RDW has a high specificity (94.7%) and low sensitivity (60%) in identifying patients with pneumonia who will develop complications. In predicting in-hospital mortality, high RDW has a sensitivity of 66.7% and specificity of 79.4%.
Conclusion: Elevated RDW is significantly associated to mortality and development of complications among pediatric patients with pneumonia. It is both specific and sensitive as a prognostic tool for pneumonia and can be a valid and cost-efficient marker for pneumonia severity.