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Published on: February 17, 2023
Diagnosis and Assessment of Severity of Pediatric Pneumonia Using the Respiratory Index of Severity (RISC) Scoring
Kalyani Pillai1, Edwin Ros Sartho1, T P Lakshmi2
1Department of Pediatrics, Amala Institute of Medical Sciences, Thrissur, Kerala.
Insights
The Respiratory Index of Severity (RISC) scoring system shows a significant correlation with chest X-rays for diagnosing and assessing childhood pneumonia severity. This tool is effective in resource-limited settings.
Area of Science:
- Pediatric Pulmonology
- Radiology
- Clinical Scoring Systems
Background:
- Pneumonia remains a leading cause of childhood mortality globally.
- Accurate diagnosis and severity assessment are crucial for effective treatment.
- Chest radiography is a standard diagnostic tool, but interpretation can be subjective.
Purpose of the Study:
- To assess the correlation between the Respiratory Index of Severity (RISC) scoring system and the World Health Organization (WHO) interpretation of chest radiographs.
- To evaluate the efficacy of the RISC scoring system in diagnosing and grading the severity of childhood pneumonia.
Main Methods:
- A study involving 241 children with a clinical diagnosis of pneumonia requiring chest X-rays.
- RISC scoring was performed by a pediatrician.
- Chest X-rays were independently graded by a radiologist using WHO criteria.
Main Results:
- A statistically significant positive correlation (P=0.02) was observed between RISC scores and WHO-based radiographic assessments.
- RISC score >1 demonstrated 80.3% sensitivity for pneumonia diagnosis.
- RISC score ≥3 showed 88.3% specificity, 61.3% positive predictive value, and 76.8% negative predictive value for severity.
Conclusions:
- The RISC scoring system is a valuable tool for diagnosing and predicting the severity of pneumonia in children.
- Its utility is particularly relevant in resource-limited settings where advanced diagnostic tools may be unavailable.
Objective:
To evaluate the correlation between the Respiratory Index of Severity (RISC) scoring system and the World Health Organization (WHO) interpretation of chest radiographs, and to evaluate the RISC scoring system in the diagnosis and assessment of severity of pneumonia in children against chest X-ray.
Methods:
241 children presenting to a tertiary care center with a clinical diagnosis of pneumonia that necessitated a chest radiograph to be taken, were enrolled. The RISC scoring was done for all participants by a single pediatrician and chest X-ray graded by a single radiologist as per the WHO interpretation of chest radiographs.
Results:
There was a statistically significant positive correlation (P=0.02) between the two scores. RISC score of >1 had a sensitivity of 80.3%, and score ≥3 had a specificity of 88.3%, positive predictive value of 61.3% and negative predictive value of 76.8% for diagnosis and to predict severity of pneumonia.
Conclusion:
In a resource-limited setting, RISC scoring can be used to diagnose and predict the severity of childhood pneumonia.
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