Comparative evaluation of AIOS score with its radiological findings in children with respiratory illness

Abstract

Background: Community-acquired pneumonia (CAP) is one of the primary causes of mortality in infants and young children. Acute Illness Observation Score (AIOS) - act as the best and accurate indicator for the same. Hence in this study, AIOS was used to relate X-ray abnormalities and pulse oximeter finding for early assessment in children with ARI. Aim and objective: the aim of the present study to compare the acute illness observational scale with radiological findings in children with respiratory illness at tertiary health care centre. Material and methods: This was a prospective, observational study was done in the Department of Paediatrics, Vardhman Institute of Medical Science (VIMS) Pawapuri, Nalanda, Bihar, India for one year. Total 100 Children in the age group of 2 months -59 months with fever less than 3 days, with cough or difficult breathing with any of the following: Fast breathing, chest in drawing, stridor in calm child, grunting, lethargy, convulsions, inability to drink were included in this study. Results: There were 13 children who scored 10 and showed no clinical features of respiratory distress. In the 22 children who scored 11-15 there was mild to moderate respiratory distress and there were 65 children with severe respiratory distress who scored >16. Among the 100 children 7% of the children had normal x-rays. Hyperinflation pertinent to bronchiolitis was seen in 25 children, End point consolidation (include dense opacity that may be a fluffy consolidation) suggestive of lobar pneumonia was present in 33 patients (33%). Non end point infiltrates defined as linear and patchy densities with peribronchial thickening and many areas of atelectasis pertinent to bronchopneumonia was seen in 23 patients (23%). The other radiological abnormalities which were rare in the study were steeple sign (5%), shock lung (5%) and pleural effusion (2%). Hyperinflation (Bronchiolitis) was present in 25 children of which 4 (16%) scored 11-15, and 19 (76%) of the patients were in >16 group. Radiological abnormalities suggestive of pneumonia was seen in 56 patients of which 14 children (25%) were in 11-15 group and 42 (75%) scored >16 of AIOS score. There           was noteworthy difference in the frequency of x-ray abnormalities between children who scored <10 and children who scored >16. Conclusion: AIOS scoring is useful in predicting abnormal x-ray findings in respiratory illness in 2-59 months old children.

Keywords: Community-acquired pneumonia, Acute Illness Observation Score.