Diagnosis and Assessment of Severity of Pediatric Pneumonia Using the Respiratory Index of Severity (RISC) Scoring System

2021 ◽  
Vol 58 (11) ◽  
pp. 1052-1055
Author(s):  
Kalyani Pillai ◽  
Edwin Ros Sartho ◽  
T. P. Lakshmi ◽  
V. K. Parvathy
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Qing Wu ◽  
Jie Wang ◽  
Mengbin Qin ◽  
Huiying Yang ◽  
Zhihai Liang ◽  
...  

Abstract Background Recently, several novel scoring systems have been developed to evaluate the severity and outcomes of acute pancreatitis. This study aimed to compare the effectiveness of novel and conventional scoring systems in predicting the severity and outcomes of acute pancreatitis. Methods Patients treated between January 2003 and August 2020 were reviewed. The Ranson score (RS), Glasgow score (GS), bedside index of severity in acute pancreatitis (BISAP), pancreatic activity scoring system (PASS), and Chinese simple scoring system (CSSS) were determined within 48 h after admission. Multivariate logistic regression was used for severity, mortality, and organ failure prediction. Optimum cutoffs were identified using receiver operating characteristic curve analysis. Results A total of 1848 patients were included. The areas under the curve (AUCs) of RS, GS, BISAP, PASS, and CSSS for severity prediction were 0.861, 0.865, 0.829, 0.778, and 0.816, respectively. The corresponding AUCs for mortality prediction were 0.693, 0.736, 0.789, 0.858, and 0.759. The corresponding AUCs for acute respiratory distress syndrome prediction were 0.745, 0.784, 0.834, 0.936, and 0.820. Finally, the corresponding AUCs for acute renal failure prediction were 0.707, 0.734, 0.781, 0.868, and 0.816. Conclusions RS and GS predicted severity better than they predicted mortality and organ failure, while PASS predicted mortality and organ failure better. BISAP and CSSS performed equally well in severity and outcome predictions.


2021 ◽  
Author(s):  
Pui-Ying Iroh Tam ◽  
James Chirombo ◽  
Marc Y.R. Henrion ◽  
Laura A. Newberry ◽  
Ivan Mambule ◽  
...  

Objective Assess characteristics of clinical pneumonia after introduction of pneumococcal conjugate vaccine (PCV), by HIV exposure status, in children hospitalized in a governmental hospital in Malawi. Methods and findings We evaluated 1,139 children ≤5 years old hospitalised with clinical pneumonia: 101 HIV-exposed uninfected (HEU) and 1038 HIV-unexposed, uninfected (HUU). Median age was 11 months (IQR 6-20), 59% were male, median mid-upper arm circumference (MUAC) was 14 cm (IQR 13-15) and mean weight-for-height z score was -0.7 (+/-2.5). The highest Respiratory Index of Severity in Children (RISC) scores were allocated to 10.4% of the overall cohort, respectively. Only 45.7% had fever, and 37.2% had at least one danger sign at presentation. The most common clinical features were crackles (54.7%), nasal flaring (53.5%), and lower chest wall indrawing (53.2%). Compared to HUU, HEU children were significantly younger (9 months v. 11 months), with lower mean birth weight (2.8 kg v. 3.0 kg) and MUAC (13.6 cm v. 14.0 cm), had higher prevalence of vomiting (32.7% v. 22.0%), tachypnoea (68.4% v. 49.8%), and highest RISC scores (20.0% v. 9.4%). Five children died (0.4%). However, clinical outcomes were similar for both groups. Conclusions In this post-PCV setting where prevalence of HIV and malnutrition is high, children hospitalised fulfilling the WHO Integrated Management of Childhood Illness criteria for clinical pneumonia present with heterogeneous features. These vary by HIV exposure status but this does not influence either the frequency of danger signs or mortality. The poor performance of available severity scores in this population and the absence of more specific diagnostics hinder appropriate antimicrobial stewardship and the rational application of other interventions.


Sari Pediatri ◽  
2018 ◽  
Vol 19 (6) ◽  
pp. 335
Author(s):  
Wigit Kristianto ◽  
Retno Asih Setyoningrum ◽  
Agoes Boediono

Latar belakang. Pneumonia masih menjadi salah satu penyebab utama morbiditas dan mortalitas anak balita di seluruh dunia. Red-cell distribution width (RDW) dan mean platelet volume (MPV) adalah dua parameter dalam pemeriksaan darah lengkap yang sederhana, murah, dan tersedia hampir di seluruh rumah sakit di Indonesia. Penggunaannya sebagai biomarker keparahan pneumonia dapat menjadi salah satu upaya untuk menurunkan morbiditas dan mortalitas akibat pneumonia.Tujuan. Menganalisis hubungan antara nilai RDW dan MPV dengan derajat keparahan pneumonia anak.Metode. Penelitian cross-sectional dilaksanakan pada Juni-November 2017 di RSUD Nganjuk, melibatkan 30 anak berusia 2-59 bulan dengan pneumonia. Nilai RDW dan MPV dihubungkan dengan klasifikasi diagnosis, derajat keparahan yang diukur menggunakan skor RISC (respiratory index of severity in children) dan PRESS (pediatric respiratory severity score), dan hasil terapi pneumonia.Hasil. Terdapat perbedaan bermakna pada nilai RDW antara subjek dengan pneumonia dan pneumonia berat (t28=-1,721, p=0,096). Nilai RDW antara kelompok dengan nilai PRESS rendah, sedang, dan tinggi juga berbeda bermakna (F(2,27)=4,083, p=0,028). Nilai RDW berhubungan bermakna kuat dengan klasifikasi diagnosis pneumonia (x(1)=0,530, p=0,004), dan berhubungan bermakna moderate dengan skor RISC (rs=0,369, p=0,023), serta skor PRESS (rs=0,318, p=0,043). Kesimpulan. Nilai RDW berhubungan dengan klasifikasi diagnosis pneumonia, skor RISC dan skor PRESS.


2021 ◽  
Vol 84 (4) ◽  
pp. 571-576
Author(s):  
I Coluoglu ◽  
E Coluoglu ◽  
H.C. Binicier ◽  
O.B. Binicier

Background/Aims: In this study, we examine the utility of Bedside Index of Severity in Acute Pancreatitis (BISAP), which is an increasingly more commonly used simple and practical novel scoring system for predicting the prognosis and severity of the disease at presentation. Materials and methods: Consecutive patients diagnosed with AP between January 2013 and December 2020 were evaluated retrospectively. The AP severity was assessed using the revised Atlanta classification (RAC). BISAP score, demographic characteristics, pancreatitis etiology, pancreatitis history, duration of hospital stay, and mortality rates of the patients were recorded. Results: A total of 1000 adult patients were included, of whom 589 (58.9%) were female and 411 (41.1%) were male. The mean age in female and male patients was 62.15 ± 17.79 and 58.1 ± 16.33 years, respectively (p >0.05). The most common etiological factor was biliary AP (55.8%), followed by idiopathic AP (23%). Based on RAC, 389 (38.9%), 418 (41.8%), and 193 (19.3%) patients had mild, moderate, and severe AP. Of the 1000 patients, 42 (4.2%) died. Significant predictors of mortality included advanced age (>65 y) (p=0.003), hypertension (p=0.007), and ischemic heart disease (p=0.001). A BISAP score of ≥3 had a sensitivity, specificity, positive predictive value, and negative predictive value (NPV) of 79.79%, 91.57%, 69.37%, and 94.99%, respectively, for determining SAP patients according to RAC. Conclusion: BISAP is an effective scoring system with a high NPV in predicting the severity of AP in the early course of the disease in a Turkish population.


PLoS ONE ◽  
2012 ◽  
Vol 7 (1) ◽  
pp. e27793 ◽  
Author(s):  
Carrie Reed ◽  
Shabir A. Madhi ◽  
Keith P. Klugman ◽  
Locadiah Kuwanda ◽  
Justin R. Ortiz ◽  
...  

2021 ◽  
Author(s):  
Qing Wu ◽  
Jie Wang ◽  
Mengbin Qin ◽  
Huiying Yang ◽  
Zhihai Liang ◽  
...  

Abstract Backgroud: Recently there are several novel scoring systems to evaluate the severity and outcomes of acute pancreatitis. This study is to compare the effectiveness of novel and traditional scoring systems for predicting severity and outcomes in acute pancreatitis.Methods: Patients between January 2003 and August 2020 were reviewed. Ranson score (RS), Glasgow score (GS), beside index of severity in acute pancreatitis (BISAP), pancreatic activity scoring system (PASS), and Chinese simple scoring system (CSSS) were determined within 48h after admission. Multivariate logistic regression was used for severity, mortality, and organ failure prediction. Optimum cutoffs were identified using ROC analysis.Results: A total of 1848 patients were included. AUCs of RS, GS, BISAP, PASS, and CSSS for severity prediction were 0.861, 0.865, 0.829, 0.778, and 0.816, respectively. AUCs for mortality prediction were 0.693, 0.736, 0.789, 0.858, and 0.759. AUCs for ARDS prediction were 0.745, 0.784, 0.834, 0.936, and 0.820. AUCs for ARF prediction were 0.707, 0.734, 0.781, 0.868, and 0.816.Conclusions: RS, and GS predict severity superior to mortality and organ failure while PASS predicts mortality and organ failure better. BISAP and CSSS shared steady capacity in severity and outcomes prediction.


1979 ◽  
Vol 10 (4) ◽  
pp. 241-245
Author(s):  
Richard J. Schissel ◽  
Linda B. James

This study examines the assumptions underlying the scoring system of the Arizona Articulation Proficiency Scale: Revised. Twenty-one children between the ages of four years two months and six years 11 months were administered the Arizona Articulation Proficiency Scale: Revised and the Screening Deep Test of Articulation. The subjects' performance on the two tests was compared for the phones: [s], [l], [r], [t∫], [θ], [∫], [k], [f], and [t]. Results suggested that 1) the production of most sounds in only two contexts does not necessarily reflect the accuracy of production of those sounds in other contexts, and 2) for the sounds tested, the weightings assigned on the basis of their frequency of occurrence rather than the frequency with which they were misarticulated overestimated the extent of many articulation errors.


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