Applicability of respiratory severity score and modified TAL criteria in pediatric age group for grading and management of acute respiratory illness

ABSTRACT

Background: Acute respiratory tract infections (ARI) are the leading cause of death in children in the world (11.9 million per year) with the greatest number of deaths occurring in developing countries like India. We compared respiratory severity scoring system RSS (Respiratory Severity Score) with Modified TAL, so that we can find out which of the above scores are better and whether they can be implemented to assess pediatric ARI patients.Methods: This prospective observational study was conducted in Pediatrics wards, Shri Vasantrao Naik Government Medical College, Yavatmal, Maharashtra and data were collected from 290 children below 12 years of age by purposive sampling. All the children presenting with respiratory symptoms were subjected to these scoring system (RSS AND MODIFIED TAL) at the time of admission and were classified based on the scores obtained in respective scoring system. Data was analysed using frequencies, percentages and contingency tables and comparison was made between the above scoring systems to find which one is better applicable in pediatric ARI patient.Results: Incidence of pediatric patients presenting with only respiratory tract infections who are admitted in ward was 25.15 %, with more incidence being reported in children below 12 months (49.31%), males more affected. For both the ARI scoring systems (RSS and MOD TAL) as the severity increased so is the number of patients requiring oxygen and duration of hospitalization increased significantly (p<0.05), with RSS having stronger association.Conclusions: Both the scoring systems predicted that on admission if the score is more than chances of requirement of oxygen is more and also duration of hospitalization is more, with RSS being better predictor.