Background: Acute respiratory illness (ARI) remains a leading cause of childhood morbidity and mortality in low-resource settings like India.This study aimed to describe the clinico-etiological profile, management, and outcomes of pediatric ARI cases presenting to the emergency department of a tertiary care hospital in Mumbai.Methods: This retrospective observational study included 80 children aged 1 month to 12 years admitted with ARI (defined per WHO criteria) over 10 months (August 2024-May 2025).Data on demographics, clinical features, investigations, treatment, and outcomes were extracted from case records.Descriptive statistics and appropriate tests assessed associations with mortality.Results: Most patients (77.5%) were aged 1 month to 5 years, with slight male predominance (55%; ratio 1.22:1).Common symptoms included increased respiratory effort (93.7%), fever (85.0%), and cough (68.8%).Undernutrition was found in 60% and incomplete immunization in 65%.Hypoxia (43.8%) and anemia (90%) were frequent; blood cultures were positive in 8.8%.Chest radiography showed abnormalities in 96.3%, with consolidation in 60%.Nonrespiratory causes contributed to 16.3% of respiratory distress.Ventilatory support was required in 86.3%, with 27.5% mortality.Significant mortality associations included residence outside Mumbai (p=0.002),abnormal nutrition (p=0.012),hypoxia (p=0.001), and inotrope duration (p=0.001). Conclusion:Severe ARI in tertiary settings carries high mortality, influenced by comorbidities, delays, and resource limitations.Non-respiratory etiologies are notable, emphasizing broad differential diagnosis.Enhancing care in peripheral areas and strengthening referral systems are the need of the hour.
Verma et al. (Mon,) studied this question.