A Study on Association of Acute Illness Observation Scale (AIOS) With Clinical Features in Pneumonia among Children Aged 2 Months to 59 Months.

Abstract

Introduction-Pneumonia is the infection of lung alveolus and parenchyma. In India, pneumonia accounts for higher burden of childhood illness. In this study we use an illness severity scoring scale- Acute illness observation scale to estimate its association with clinical features, need for oxygen therapy, ICU admission and length of hospital stay in children with pneumonia aged between two to fifty-nine months.

Materialsand Methods- A cross-sectional study was conducted over a period of 1 year in the pediatric department of Sree Balaji medical college and hospital, Chromepet, Chennai. Children between two months to fifty-nine months of age with pneumonia were scored with Acute illness observation score and further subdivided into three categories namely well-looking (AIOS less than or equal to 10), ill-looking (12 and 14) and severely ill-looking (more than or equal to 16). Clinical features, need for oxygen support, ICU admission and length of stay were compared between the groups.

Results- This study included 133 male and 105 female children. The incidence of pneumonia was high in 6-11 months age group. 27.3% had severe pneumonia.39.1% were well-looking, 32.8% ill- looking and 28.2% were seriously-ill-looking. Duration of fever, cough and fast breathing were significantly higher (p<0.001) in the seriously-ill-looking group. Seriously-ill-looking children had significantly higher prevalence (p<0.001) of general danger signs ofIMNCI (49.3%),chest indrawing (80.6%), stridor (28.4%), prolonged capillary refill time (22.4%), abnormal breath sounds (98.5%), oliguria (20.9%), radiological evidence of pneumonia (92.5%) and leukocytosis (98.5%) with a significant trend among the three categories for these variables. Oxygen support requirement (74.6%vs 5.1% vs 1.1%) and need for ICU admission (52.2% vs 3.8% vs 0%) was significantly higher in the seriously-ill-looking group than ill-looking and well-looking groups. Length of stay was significantly higher (p<0.001) in the seriously-ill-looking group than other groups. AIOS score had high positive correlation with need for oxygen support (τb=0.594), need for ICU admission (τb=0.496) and length of hospital stay (τb=0.619).

Conclusion-AIOS scoring system can be used to assess the severity of pneumina and can be used for prognosticating the clinical outcomes of pneumonia.