Acute Illness Observation Scale in community acquired pneumonia in children aged 2 months to 59 months
DOI:
https://doi.org/10.18203/2349-3291.ijcp20202154Keywords:
Acute illness observation scale, Hypoxemia, Pneumonia, TachypneaAbstract
Background: Pediatric respiratory disease remains an important cause of morbidity in both the developing and the developed world. Aim of the study is to validate Acute Illness Observation Scale (AIOS) in predicting illness severity and clinical outcome of community acquired pneumonia.
Methods: This was a descriptive study done in a cohort of 248 children at the Department of Paediatrics, at a tertiary care hospital in Chennai. Children between 2 months - 59 months coming to outpatient department with suspected pneumonia, if satisfying the inclusion criteria were enrolled into the study. AIOS scoring is done on each subject on day 1, day 2, day 5 by two persons simultaneously in a reasonably quite state. Respiratory parameters, vital signs and pulseoximeter reading of each patient as in data collection form are documented.
Results: Children scoring abnormally on AIOS (>10) had significantly higher frequency of severe tachypnea (p=0.001), marked chest retraction (p=0.001), grunting, cyanosis (p=0.01), lethargy, inability to drink and so on except incidence of convulsion and wheeze which didn’t have any statistical significance. Severe hypoxemia associated with cyanosis (SpO2<85) was observed in 14 children of which 92.9% (13) scored a high value on AIOS (AIOS>15). Complications were absent in those who scored <10, while maximum complications were seen in those who scored >15.
Conclusions: AIOS can be used as a tool to decide on therapeutic modalities and prognosticating a child with pneumonia admitted to the hospital by a physician.
References
Armon K, Stephenson T, Gabriel V, MacFaul R, Eccleston P, Werneke U, et al. Determining the common medical problems presenting to an accident and emergency department. Arch Dis Child. 2001;84:390-2.
WHO Programme for the control of acute Respiratory infections. Acute Respiratory infections in children: Case management in Small hospitals in developing countries. Geneva: World Health Organisation, 1990.
Nolan T, Angos P, Cunha AJ, Muhe L, Qazi S, Simoes EA, et al. Quality of Hospital care for seriously ill children in less developed countries. Lancet 2001;357:106-10.
Bharti B, Bharti S, Verma V. Role of Acute Illness Observation Scale (AIOS) in managing severe childhood pneumonia. Indian J Pediatr. 2007;74(1):27-32.
Mc Carthy PL, Jekel JF, Stashwick CA, Spiesel SZ, Dolan TF Jr. History and observation variables in assessing febrile children. Pediatrics. 1980;65:1090-5
Mc Carthy PL, Jekel JF, Stashwick CA, Spiesel SZ, Dolan TF, Sharpe MR et al. Further definition of history and observation variables in assessing febrile children. Pediatrics. 1981;67:687-93.
McCarthy PL, Sharpe MR, Spiesel SZ, Dolan TF, Forsyth BW, DeWitt TG, et al. Observation scales to identify serious illness in febrile children. Pediatric. 1982;70:802-9
Mc Carthy PL, Lembo RM, Baron MA, Fink HD, Cichetti DV. Predictive value of abnormal physical examination findings in ill-appearing and well-appearing febrile children. Pediatrics. 1985;76:167-171.
Mc Carthy PL, Lembo RM, Baron MA, Fink HD, Cichetti DV. Observation, history and physical examination in diagnosis of serious illnesses in febrile children. J Pediatr. 1987;110:26-30.
Bang AT, Bang RA, Reddy MH, Baitule SB, Deshmukh MD, Paul VK et al. Simple clinical criteria to identify sepsis or pneumonia in neonates in the community needing treatment or referral. Pediatr Clin North Am. 1998;45:65-77.
Weber MW, Usen S, Palmer A, Jaffar S, Mulholland EK. Predictors of hypoxaemia in hospital admissions with acute lower respiratory tract infection in a developing country. Arch Dis Child. 1997;76:310-4.
Rajesh VT, Singhi S, Kataria S. Tachypnea is a good predictor of hypoxia in acutely ill children. Arch Dis Child. 2000;82:46-9.
