Identifying the Risk Factors for Sepsis in Pediatric Patients with Community-acquired Pneumonia

Background: Community-acquired pneumonia (CAP), which is classified as pneumonia acquired outside healthcare settings, can progressively develop into sepsis—a leading cause of death in children if not properly managed. The risk factors for CAP-induced sepsis may vary with age due to differences in immune maturity, developmental factors, and the underlying causes of pneumonia. This study aims to identify the risk factors associated with CAPinduced sepsis, focusing on the demographic and clinical characteristics. Objective: This study aimed to determine the risk factors associated with the occurrence of sepsis in pediatric patients with CAP, with an emphasis on both the demographic and clinical risk factors. Methods: This cohort study included cases of CAP in children aged 1 month to 17 years, and their disease progression was followed up to determine whether or not they developed sepsis. The univariate analysis was performed using the chi-square and Fische's exact tests, while the multivariate analysis was performed using multiple logistic regression. Results: Of the 107 pediatric patients with CAP, 90 children met the inclusion criteria. Of them, 20 developed sepsis, while 70 recovered. The data analysis from this study identified two factors that significantly increase the risk of a child with CAP developing sepsis. These factors were temperature (RR 3.5 [95% confidence interval (CI) 1.269~9.652]; p = 0.007) and absolute neutrophil count (ANC) (RR 3.5 [95% CI 1.708~7.171]; p = 0.021). Conclusion: Temperature and ANC were found to be significant independent risk factors that may increase the likelihood of sepsis in children with CAP. Although these factors were significant in this study, future research is needed to determine how these risk factors vary by age, and CAP etiology can further refine early sepsis risk identification and improve targeted management strategies