Details:

Alternative Title:
PLoS One
Publisher's site:
http://dx.doi.org/10.1371/journal.pone.0092968
Personal Author:
Emukule, Gideon O. ; McMorrow, Meredith ; Ulloa, Chulie ; Khagayi, Sammy ; Njuguna, Henry N. ; ... More +
Emukule, Gideon O. ; McMorrow, Meredith ; Ulloa, Chulie ; Khagayi, Sammy ; Njuguna, Henry N. ; Burton, Deron ; Montgomery, Joel M. ; Muthoka, Philip ; Katz, Mark A. ; Breiman, Robert F. ; Mott, Joshua A. Less -
Description:
Background

Pediatric respiratory disease is a major cause of morbidity and mortality in the developing world. We evaluated a modified respiratory index of severity in children (mRISC) scoring system as a standard tool to identify children at greater risk of death from respiratory illness in Kenya.

Materials and Methods

We analyzed data from children <5 years old who were hospitalized with respiratory illness at Siaya District Hospital from 2009–2012. We used a multivariable logistic regression model to identify patient characteristics predictive for in-hospital mortality. Model discrimination was evaluated using the concordance statistic. Using bootstrap samples, we re-estimated the coefficients and the optimism of the model. The mRISC score for each child was developed by adding up the points assigned to each factor associated with mortality based on the coefficients in the multivariable model.

Results

We analyzed data from 3,581 children hospitalized with respiratory illness; including 218 (6%) who died. Low weight-for-age [adjusted odds ratio (aOR) = 2.1; 95% CI 1.3–3.2], very low weight-for-age (aOR = 3.8; 95% CI 2.7–5.4), caretaker-reported history of unconsciousness (aOR = 2.3; 95% CI 1.6–3.4), inability to drink or breastfeed (aOR = 1.8; 95% CI 1.2–2.8), chest wall in-drawing (aOR = 2.2; 95% CI 1.5–3.1), and being not fully conscious on physical exam (aOR = 8.0; 95% CI 5.1–12.6) were independently associated with mortality. The positive predictive value for mortality increased with increasing mRISC scores.

Conclusions

A modified RISC scoring system based on a set of easily measurable clinical features at admission was able to identify children at greater risk of death from respiratory illness in Kenya.


Subject:
[+]
Child, Preschool
Female
Hospitalization
Humans
Infant
Infant, Newborn
Male
Models, Statistical
Morbidity
Referral And Consultation
Research Article
Respiratory Tract Diseases
ROC Curve
Severity Of Illness Index

Source:
PLoS One. 2014; 9(3).
Document Type:
Journal Article
Place as Subject:
Kenya
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:b945a3e6ce1e97fea1508bc901d97f7f3a5e35ecaf038540124e90cfc0c7c14d
File Type:

Supporting Files

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