{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T21:16:35Z","timestamp":1773350195148,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Adverse in\u2010hospital outcomes of childhood pneumonia are well\u2010documented, but adverse postdischarge outcomes remain unclear, especially in middle\u2010income countries. We investigated factors associated with in\u2010hospital and postdischarge adverse outcomes in Malaysian children with pneumonia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between April 2022 and April 2023, a prospective cohort of Malaysian children aged 1 month to &lt;\u200912 years hospitalized with radiographic\u2010confirmed pneumonia were enrolled and reviewed 4\u20136 weeks postdischarge. Composite in\u2010hospital adverse outcomes were death, intensive care admission, or prolonged hospitalization &gt;\u20095 days. Composite postdischarge adverse outcomes were chronic (&gt;\u20094 weeks) wet cough, rehospitalization for acute lower respiratory infection (ALRI), or unscheduled respiratory\u2010related doctor visit by 4\u20136 weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In 868 children, composite in\u2010hospital adverse outcomes occurred in 139 (16%) (2 deaths [&lt;\u20091%], 46 [5%] intensive care admissions, 136 [16%] prolonged hospitalizations). Risk factors for in\u2010hospital adverse outcomes were: age &lt;\u20096 months (adjusted odds ratio [OR\n                      <jats:sub>adj<\/jats:sub>\n                      ]\u2009=\u20093.84, 95% confidence interval [CI] 2.13\u20136.93), preterm birth (OR\n                      <jats:sub>adj\u2009<\/jats:sub>\n                      =\u20091.81, 95% CI 1.01\u20133.23), partial\/unvaccinated status (OR\n                      <jats:sub>adj\u2009<\/jats:sub>\n                      =\u20092.28, 95% CI 1.13\u20134.60), hypoxemia (OR\n                      <jats:sub>adj\u2009<\/jats:sub>\n                      =\u20094.91, 95% CI 2.95\u20138.20), airspace abnormalities (OR\n                      <jats:sub>adj\u2009<\/jats:sub>\n                      =\u20099.80, 95% CI 3.84\u201324.98), and anemia (OR\n                      <jats:sub>adj\u2009<\/jats:sub>\n                      =\u20091.70, 95% CI 1.08\u20132.68). Among 689\/866 (80%) children reviewed postdischarge, 666 (97%) had complete data. Of these, composite postdischarge outcomes occurred in 134 (20%) children (20 [3%] chronic wet cough, 71 [11%] hospitalized ALRIs, 128 [19%] unscheduled respiratory\u2010related doctor visits). Preterm birth (OR\n                      <jats:sub>adj\u2009<\/jats:sub>\n                      =\u20092.28, 95% CI 1.37\u20133.81) and invasive mechanical ventilation (OR\n                      <jats:sub>adj\u2009<\/jats:sub>\n                      =\u20092.64, 95% CI 1.16\u20136.00) were risk factors for postdischarge adverse outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Children hospitalized with radiographic\u2010confirmed pneumonia and at risk of in\u2010hospital adverse outcomes should be monitored closely. Postdischarge follow\u2010up is recommended for preterm children or those requiring invasive mechanical ventilation because of their risk of long\u2010term respiratory morbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71380","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T12:49:29Z","timestamp":1763124569000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Factors Associated With In\u2010Hospital and Postdischarge Adverse Outcomes Among Children Hospitalized With Community\u2010Acquired Pneumonia in Sabah, Malaysia: A Prospective Cohort Study"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9781-5905","authenticated-orcid":false,"given":"Hing Cheong","family":"Kok","sequence":"first","affiliation":[{"name":"Child and Maternal Health Division, Menzies School of Health Research Charles Darwin University Darwin NT 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Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith","family":"Grimwood","sequence":"additional","affiliation":[{"name":"Child and Maternal Health Division, Menzies School of Health Research Charles Darwin University Darwin NT Australia"},{"name":"School of Medicine and Dentistry Griffith University Gold Coast Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian Brent","family":"Masters","sequence":"additional","affiliation":[{"name":"Australian Centre for Health Services Innovation and School of Medicine Queensland University of Technology Brisbane Queensland Australia"},{"name":"Department of Respiratory and Sleep Medicine Queensland Children's Hospital Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle B.","family":"McCallum","sequence":"additional","affiliation":[{"name":"Child and Maternal Health Division, Menzies School of Health Research Charles Darwin 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