Utility of the acute illness observational scale in predicting pneumonia outcomes in children

Background. In order to proper diagnose the children with community acquired pneumonia (CAP), an approach was needed. Current study validate the efficacy of Acute Illness Observational Scale (AIOS) score to determine the severity of the illness and the outcome of CAP in children. Method. This descriptive observational study was conducted on 100 children aged 2 months to 5 years who presented with cough and fever, along with lethargy, chest indrawing, fast breathing, or inability to drink. AIOS scores were assessed on days 1, 2, and 5. Laboratory tests and chest X-rays were performed, and outcomes were recorded. Results. Chest X-rays revealed infiltrates in 52% of cases and consolidation in 16%. At initial assessment, 45% of cases had an abnormal AIOS score (>16), while 15% scored between 11 and 15. Among children with scores >16, 2% required inotropic support, and another 2% needed mechanical ventilation. Out of the treatment modalities, 39 out of 58 children (58.2%) who received intravenous fluids had AIOS score >16. Additionally, 45 out of 80 children treated with intravenous antibiotics also had scores >16, indicating a significant correlation (p < 0.05). In contrast, 20 children received oral antibiotics had AIOS scores <10. Overall, 55% of patients were discharged after an average hospital stay of 6.73 days (range: 6 to 15 days). A strong linear correlation was found between AIOS scores and WHO severity grading (r = 0.695), and a moderate positive correlation between the duration of hospitalization and AIOS scores (r=0.472). The duration of hospitalization was positively correlated with the AIOS score (r=0.5, P < 0.0001). Conclusion. The AIOS score is significantly associated with abnormal radiographic findings and various treatment strategies. Higher AIOS scores are predictive of longer hospital stays and greater illness severity. This study contributes to existing literature by demonstrating a strong correlation between AIOS scores and clinical severity of pneumonia in resource-limited settings.