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Ref Number = PITIKA-ASPR0414
RISK FACTORS OF CONGESTIVE HEART FAILURE IN CHILDREN WITH PNEUMONIA AND CONGENITAL HEART DISEASE
Dimarzsiana Dara Sjahruddin, Dian Yashifa, Retno Asih Setyoningrum, I Ketut Alit Utamayasa, Mahrus A Rahman, Teddy Ontoseno
OBJECTIVE: Pneumonia is a common cause of childhood morbidity and mortality. Congenital heart disease (CHD) may predispose their suffer to congestive heart failure (CHF). The purpose of this research was to evaluate the contribution of CHD to CHF in children with pneumonia in Dr. Soetomo Hospital.
METHOD: This case control study was evaluating children aged less than 1 year old with pneumonia and congenital heart disease from January 2016 to December 2018 at Dr. Soetomo Academic General Hospital Surabaya. Diagnosis of pneumonia was based on World Health Organization criteria, confirmed by chest X-ray. CHD were evaluated by echocardiography. CHF was diagnosed when children fulfilment of at least three of the four criteria such as significant tachycardia, significant tachypnea, cardiomegaly and tender hepatomegaly. The risk factors for CHF consist of age, gender, nutritional status, prematurity, birth weight, severity of pneumonia, type of CHD and anemia (Haemoglobin level <10g/dL). Chi square and logistic regression was used to analyse the data (p<0.05). 
RESULT : A total of 90 children were evaluated, grouped into CHF group as case (n=40) and without CHF as control group (n=50). About 53% were boys, and 64% aged ? 6 months old. Comparison of case and control who had severe malnutrition was 42.5% vs 46% (OR 0.868: 95%CI 0.375 to 2.006), prematurity (22.5% vs 28%: OR 1.340: 95% CI 0.510 to 3.517). Logistic regression revealed only severity of pneumonia (adjusted OR=3.531, 95%CI 1.200 to 10.391; P=0.022) was significantly correlated with CHF. Age, gender, nutritional status, prematurity, birth weight, type of CHD and anemia were not significantly related to CHF.
CONCLUSION : Severe pneumonia can predict the risk of CHF in pneumonia children with CHD.
Keywords: Pneumonia, Congenital heart disease, Congestive heart failure.
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