TY - JOUR

T1 - Development and an initial validation of the Responses to Illness Severity Quantification (RISQ) score for severely malnourished children

AU - Dale, Nancy M

AU - Ashir, Garba Mohammed

AU - Maryah, Lawan Bukar

AU - Shepherd, Susan

AU - Tomlinson, George

AU - Briend, André

AU - Zlotkin, Stanley

AU - Parshuram, Christopher

N1 - This article is protected by copyright. All rights reserved.

PY - 2022

Y1 - 2022

N2 - Aim: To develop and perform an initial validation of a score to measure severity of illness in hospitalized children with severe acute malnutrition (SAM).Methods: A prospective study enrolled SAM children aged 6-59 months hospitalized in Borno State, Nigeria. Candidate items associated with inpatient mortality were combined and evaluated as candidate scores. Clinical and statistical methods were used to identify a preferred score.Results: The 513 children enrolled had a mean age of 15.6 months of whom 48 (9%) died. Seven of the ten evaluated items were significantly associated with mortality. Five different candidate scores were tested. The final score, Responses to Illness Severity Quantification (RISQ), included 7 items: heart rate, respiratory rate, respiratory effort, oxygen saturation, oxygen delivery, temperature and level of consciousness. The mean RISQ score on admission was 2.6 in hospital survivors and 7.3 for children dying <48hr. RISQ scores <24hr before death had an area under the receiver operating characteristic curve (AUROC) of 0.93. The RISQ score performed similarly across differing clinical conditions with AUROCs 0.77-0.98 for all conditions except oedema.Conclusion: The RISQ score can identify high risk malnourished children at and during hospital admission. Clinical application may help prioritize care and potentially improve survival.

AB - Aim: To develop and perform an initial validation of a score to measure severity of illness in hospitalized children with severe acute malnutrition (SAM).Methods: A prospective study enrolled SAM children aged 6-59 months hospitalized in Borno State, Nigeria. Candidate items associated with inpatient mortality were combined and evaluated as candidate scores. Clinical and statistical methods were used to identify a preferred score.Results: The 513 children enrolled had a mean age of 15.6 months of whom 48 (9%) died. Seven of the ten evaluated items were significantly associated with mortality. Five different candidate scores were tested. The final score, Responses to Illness Severity Quantification (RISQ), included 7 items: heart rate, respiratory rate, respiratory effort, oxygen saturation, oxygen delivery, temperature and level of consciousness. The mean RISQ score on admission was 2.6 in hospital survivors and 7.3 for children dying <48hr. RISQ scores <24hr before death had an area under the receiver operating characteristic curve (AUROC) of 0.93. The RISQ score performed similarly across differing clinical conditions with AUROCs 0.77-0.98 for all conditions except oedema.Conclusion: The RISQ score can identify high risk malnourished children at and during hospital admission. Clinical application may help prioritize care and potentially improve survival.

KW - Faculty of Science

KW - Malnutrition

KW - Severity of illness

KW - Score

KW - Mortality

KW - Child

U2 - 10.1111/apa.16410

DO - 10.1111/apa.16410

M3 - Journal article

C2 - 35582782

VL - 111

SP - 1752

EP - 1763

JO - Acta Paediatrica

JF - Acta Paediatrica

SN - 0803-5253

IS - 9

ER -