Acute illness observational scale in community acquired pneumonia in tertiary care unit in age group of 2 months to 5 years

Background: Community-acquired pneumonia (CAP) remains the leading cause of under-five mortality in India. The Acute Illness Observation Score (AIOS), developed by P. L. McCarthy, offers a systematic approach to assess illness severity based on six observable factors in pediatric patients. Methods: A prospective, cross-sectional study conducted at a Department of Paediatrics, Guru Gobindsingh Government Hospital and Shri M P Shah Government Hospital, Jamnagar and enrolled 210 children aged 2-59 months with CAP. After obtaining institutional ethical clearance and parental consent, patients were assessed using AIOS criteria at admission and day 5, monitoring clinical outcomes and treatment responses. Results: Children with abnormal AIOS scores (>10) at admission showed significantly higher rates of tachypnea (p:0.001), severe respiratory distress (p<0.001), and feeding difficulties. Among severe pneumonia cases, 56.7% required oxygen support and advanced antibiotics. Breastfeeding and complete immunization emerged as protective factors. Comparison between admission and day 5 AIOS scores demonstrated significant improvement with treatment. Conclusions: AIOS proves to be a reliable and effective tool for evaluating CAP severity in pediatric patients. Strong correlations between AIOS scores and clinical outcomes validate its utility in guiding treatment decisions and predicting prognosis, particularly in resource-limited settings, making it a valuable adjunct to clinical judgment.