Determine the Severity of Acute Respiratory Infections by Using Pediatric Respiratory Severity Score (PRESS) in Children Visiting Federal Govt. Polyclinic hospital, Islamabad

Abstract

Objective: To determine the severity of acute respiratory infections in children by using Pediatric Respiratory Severity Score (PRESS).

Methodology: This descriptive cross sectional study was conducted at the outpatient and emergency paediatric department of the Federal Govt. Polyclinic hospital, Islamabad, from October 2017 to December 2019. One hundred and seventeen children with acute respiratory infections were enrolled in the study by a non-probability sampling technique. Epidemiologic variables of interest included age, sex, and breastfeeding or not. Clinical variables of interest included respiratory rate, use of accessory respiratory muscle, wheeze on auscultation, and oxygen saturation at room air.  PRESS assessed tachypnea, wheezing, accessory muscle use, SpO2 and feeding difficulties with each component given a score of 0 or 1, and the total score were categorized as a mild(0-1), moderate (2-3) or severe(4-5).

Results: Out of 117 children, 98 (83.8%) belonged to the age group > 2 months– 12 months, while 19 (16.2%) belonged to the age group > 12 months– 24 months. Among them, 17 (14.5%) were mild, 53 (45.3%) were moderate, and 47 (40.2%) were severe according to their severity of respiratory distress. The hospitalization rate for moderate infection was 84.9% while 100% for severe infection and none of the patient with mild infection was hospitalized (p<0.001).

Conclusion: Early assessment by simple bedside technique will help in managing the respiratory distress according to its severity, reducing the undue investigation and improving the outcome of illness. Moreover it can be easily administered at primary health care facilities for triage of pediatric patients with respiratory distress.