Predictors of the severity of pneumonia have not been thoroughly
evaluated among children in developed countries. We investigate whether
chest radiographic findings could be used as predictors of severity of
childhood pneumonia. The study included 167 children, aged more than 12
months, hospitalized in our department during a 4-year period with
unilateral lobar or segmental pneumonia. The durations of fever and of
hospitalization were considered indicators of severity of the disease.
The size of the consolidation and its location in the left hemithorax
were independently associated with severity of the disease. Univariate
analysis showed that the mean duration of fever and of hospitalization
as well as the prevalence of pleural effusion was significantly higher
among children with left-sided pneumonia. A multiple logistic regression
analysis revealed that only the presence of pleural effusion was
significantly more likely in left-sided pneumonia (odds ratio, 2.65;
95% confidence interval, 1.09-6.47; P = 0.031). We conclude that the
size of consolidation and the side of its location can be used as
predictors of severity of pneumonia, with left-sided pneumonia running a
more severe course, possibly due to increased risk for the development
of pleurisy. (C) 2004 Wiley-Liss, Inc
