Online Tool for Predicting Severe Cases of Childhood Community-Acquired Pneumonia Based on the PIRO Concept.

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Pulmonology Pub Date : 2025-07-01 DOI:10.1002/ppul.71199

Xin Long, Wanling Li, Yuyi Tang, Zhengxiu Luo, Jian Luo, Zhou Fu, Enmei Liu, Ximing Xu, Yu Deng

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引用次数: 0

Abstract

Background: Pneumonia remains a leading cause of mortality among children under 5 years of age. This study aimed to compare existing prognostic scoring systems and identify the most effective tool for assessing outcomes in children with community-acquired pneumonia (CAP).

Methods: The Predisposition, Insult, Response, and Organ Dysfunction score for CAP (PIRO-CAP) was modified to create the Ch-online PIRO score based on a comprehensive cohort study. This new scoring system was validated in a cohort of 75,965 children under the age of 5 years with CAP, treated at the Children's Hospital of Chongqing Medical University between 2016 and 2021. Effectiveness in predicting severe cases was then compared against the Pediatric Critical Illness Score (PCIS), Pneumonia Etiology Research for Child Health (PERCH) score, and PIRO-CAP score.

Results: The Ch-online PIRO score retained most of the original PIRO-CAP factors, including age under 6 months, comorbidities, SpO₂ below 90%, multilobar or complicated pneumonia, kidney or liver dysfunction, and respiratory failure, but replaced hypotension and bacteremia with delayed capillary refill time (> 3 s) and procalcitonin > 0.5 ng/mL. When predicting severe CAP cases, the Ch-online PIRO score demonstrated superior discriminatory performance (AUC = 0.85, 95% CI: 0.85-0.86) compared to the PCIS (AUC = 0.67, 95% CI: 0.66-0.69), PERCH score (AUC = 0.64, 95% CI: 0.64-0.65), and PIRO-CAP score (AUC = 0.68, 95% CI: 0.64-0.71).

Conclusion: The Ch-online PIRO score shows promise as an effective prognostic tool for assessing the severity of CAP in young children.

查看原文本刊更多论文

基于PIRO概念预测儿童社区获得性肺炎重症病例的在线工具。

背景：肺炎仍然是5岁以下儿童死亡的主要原因。本研究旨在比较现有的预后评分系统，并确定评估社区获得性肺炎（CAP）儿童预后的最有效工具。方法：在综合队列研究的基础上，对CAP的易感、侮辱、反应和器官功能障碍评分（PIRO-CAP）进行修改，创建Ch-online PIRO评分。这个新的评分系统在2016年至2021年期间在重庆医科大学儿童医院接受治疗的75,965名5岁以下CAP儿童中进行了验证。然后将预测重症病例的有效性与儿科危重疾病评分（PCIS）、儿童健康肺炎病因学研究（PERCH）评分和PIRO-CAP评分进行比较。结果：Ch-online PIRO评分保留了大部分原始的iro - cap因素，包括年龄小于6个月、合并症、SpO2低于90%、多叶性或合并症肺炎、肾功能或肝功能障碍、呼吸衰竭，但以毛细血管再充盈时间延迟（>.3 s）和降钙素原> 0.5 ng/mL取代了低血压和菌血症。在预测严重CAP病例时，Ch-online PIRO评分与PCIS （AUC = 0.67, 95% CI: 0.66-0.69）、PERCH评分（AUC = 0.64, 95% CI: 0.64-0.65）和PIRO-CAP评分（AUC = 0.68, 95% CI: 0.64-0.71）相比，显示出更好的歧视性表现（AUC = 0.85, 95% CI: 0.85-0.86）。结论：Ch-online PIRO评分有望作为评估幼儿CAP严重程度的有效预后工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Pulmonology 医学-呼吸系统

CiteScore

6.00

自引率

12.90%

发文量

468

审稿时长

3-8 weeks

期刊介绍： Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases. PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.