Related Experiment Video
Updated: Jan 28, 2026
Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
Published on: June 28, 2018
Mortality Predictive Scores for Community-Acquired Pneumonia in Children
Antonio Arbo1,2,3, Dolores Lovera4,5, Celia Martínez-Cuellar4,5
1Department of Pediatric, Instituto de Medicina Tropical, Avda. Venezuela y Florida, Asunción, Paraguay. antonioarbo@hotmail.com.
Insights
Pediatric pneumonia severity scoring is crucial but lacks tools for developed nations. New prognostic scales adapted for developed countries are needed to accurately estimate childhood pneumonia mortality.
Area of Science:
- Pediatrics
- Infectious Diseases
- Critical Care Medicine
Background:
- Accurate staging of pneumonia severity is essential for guiding patient management.
- Established prognostic scoring systems are widely available for adult community-acquired pneumonia (CAP).
- A scarcity of validated severity scores exists for pediatric pneumonia, particularly in developed countries.
Purpose of the Study:
- To review the current landscape of pneumonia severity scoring systems for children.
- To highlight the limitations of existing scores in developed healthcare settings.
- To advocate for the development of novel prognostic tools tailored for pediatric CAP in developed nations.
Main Methods:
- Review of recently developed pediatric pneumonia risk stratification scoring systems.
- Analysis of clinical variables used in existing scores (e.g., hypoxemia, chest indrawing, malnutrition, HIV stage).
- Evaluation of the applicability of scores from low- and middle-income countries to developed countries.
Main Results:
- Several pediatric pneumonia scoring systems have been developed in low- and middle-income countries, demonstrating good discrimination.
- These scores utilize clinical factors known to predict severe outcomes in children.
- However, patient characteristics, local epidemiology, and healthcare facilities limit their direct applicability in developed countries.
- Existing scores for childhood CAP mortality are predominantly from developing countries, limiting their utility in developed nations.
Conclusions:
- There is a critical need for pediatric pneumonia severity scores applicable to developed countries.
- A modified prognostic scale, potentially based on adult PIRO (Pneumonia-specific score, Immune status, Response to treatment, Organ dysfunction) criteria, could be beneficial.
- Prospective studies are required to develop and validate pneumonia scoring systems adapted to the specific context of developed healthcare systems.
Purpose Of Review:
The use of severity score for the staging of pneumonias has emerged as a necessity for the physician caring for this disease. Although there are several established prognostic scoring systems for community-acquired pneumonia in adults, the availability for children are scarce.
Recent Findings:
Recently, scoring system for risk stratification of children with pneumonia were developed in low- and middle-income countries. They use clinical variables that represent known risk factors for severe outcomes of respiratory illness in children, such as hypoxemia, chest indrawing, refusal to feed, malnutrition, age, and stage of HIV disease among others factors. Although they showed good discriminating power and are very useful in low-resource settings, the characteristics of the patients, the local epidemiology of concurrent diseases, the social conditions, and the facilities of the hospitals make them not applicable to developed countries. A new prognostic scale for estimating mortality based on the modified PIRO scale used in adults with pneumonia can be useful for developed countries. Although several scoring systems for the estimation of mortality in childhood CAP were developed in the last years, most of them come from developing countries and the results are not applicable to patients with pneumonia in developed countries. Prospective studies applying scores adapted to the reality of the developed countries are needed.
Related Concept Videos
00:30What are Populations and Communities?
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:29Pneumonia II: Pathophysiology
01:06Introduction to z Scores
z scores...
01:05Introduction to z Scores
z scores...
01:17z Scores and Area Under the Curve