Analysis of risk factors for otitis media in hospitalized children aged ≤ 12 years with bacterial pneumonia.

Abstract

Background: To analyze the risk factors for otitis media in children aged ≤ 12 years who develop the condition after being hospitalized for bacterial pneumonia.

Methods: A total of 411 hospitalized patients aged ≤ 12 years with bacterial pneumonia, admitted between November 2023 and March 2025, were included. Demographic data, birth history, feeding history, and laboratory indicators were recorded to assess their connection with the development of otitis media after hospitalization. First, univariate logistic regression was performed, followed by multivariate logistic regression using a backward stepwise method to establish the final predictive model. The model's effectiveness was assessed based on the AUC (area under the ROC curve), calibration plots, and decision curve analysis (DCA).

Results: Patients were stratified into two groups based on the occurrence of otitis media: the non-otitis media group (n = 303) and the otitis media group (n = 108). The study found that several factors were significantly associated with the risk of developing otitis media in children hospitalized with bacterial pneumonia: age 3-12 years (OR: 0.51, 95%CI: 0.26-0.97, p = 0.012), infection with Haemophilus influenzae (HI) (OR: 1.91, 95%CI: 1.07-3.42, p = 0.027), antibiotic use prior to admission (OR: 2.54, 95%CI: 1.29-5.27, p = 0.009), platelet count (OR: 1.00, 95%CI: 1.00- 1.01, p = 0.002), hemoglobin level (OR: 0.95, 95%CI: 0.93-0.98, p < 0.001), alanine aminotransferase (ALT) (OR: 1.04, 95%CI: 1.01-1.07, p = 0.019), creatine kinase (CK) (OR: 1.02, 95%CI: 1.01-1.04, p < 0.001), lactate dehydrogenase (OR: 1.00, 95%CI: 1.00-1.01, p = 0.049). The final model showed that age ≤ 3 years, HI infection, take antibiotics, higher monocyte count, higher PLT, lower HGB, higher ALT, higher CK and LDH were risk factors for OM.

Conclusion: The results emphasize the role of demographic characteristics, birth history, feeding history, and laboratory indicators in the risk of developing otitis media during hospitalization in children aged ≤ 12 years with bacterial pneumonia. Incorporating these risk factors into clinical practice may enhance early identification, guide targeted prevention strategies, and ultimately improve outcomes in high-risk populations.