Predictive value of Respiratory Index of Severity in Children (RISC) in children with Lower Respiratory Tract Infections

Abstract

Background:Toassess the predictive value of Respiratory Index of Severity in Children (RISC) in children with Lower Respiratory Tract Infections (LRTI). Method:This retrospective study included a total of 154 children records aged 1-24 months hospitalized for LRTI. Severity of Pneumonia was assessed using Integrated Management of Neonatal and Childhood Illness (IMNCI) classification. Presenting signs, nutritional status (z-score for weight for age), ability to eat were noted and RISC score was calculated. All the children were    followed up till their hospital stay through file records. The outcome was noted as discharge after recovery or death. RISC score>4 was considered as predictor of mortality. Patients leaving against medical advice were excluded from assessment. Chi-square test was used for comparison. Sensitivity, specificity, positive and negative  predictive value were calculated. Results:Mean age of children was 15.41±7.80 months. Majority (65.6%) were males. As per IMNCI Classification, 35 (22.7%) had severe and 44 (28.7%) had very severe/severe pneumonia. A total of 14 (9.1%) patients had RISC score >4. There were 11 (6.5%) deaths. Both higher IMNCI class and RISC scores were significantly associated with mortality. IMNCI severe/very severe was 100% sensitive and 49.6% specific whereas RISC >4 was 90.9% sensitive and 97% specific in prediction of mortality. Conclusion:RISC score had high sensitivity and specificity in prediction of mortality among children hospitalized for LRTI.