{"title":"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。","authors":"Xin Long, Wanling Li, Yuyi Tang, Zhengxiu Luo, Jian Luo, Zhou Fu, Enmei Liu, Ximing Xu, Yu Deng","doi":"10.1002/ppul.71199","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>The Ch-online PIRO score retained most of the original PIRO-CAP factors, including age under 6 months, comorbidities, SpO<sub>2</sub> 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).</p><p><strong>Conclusion: </strong>The Ch-online PIRO score shows promise as an effective prognostic tool for assessing the severity of CAP in young children.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 7","pages":"e71199"},"PeriodicalIF":2.7000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261875/pdf/","citationCount":"0","resultStr":"{\"title\":\"Online Tool for Predicting Severe Cases of Childhood Community-Acquired Pneumonia Based on the PIRO Concept.\",\"authors\":\"Xin Long, Wanling Li, Yuyi Tang, Zhengxiu Luo, Jian Luo, Zhou Fu, Enmei Liu, Ximing Xu, Yu Deng\",\"doi\":\"10.1002/ppul.71199\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>The Ch-online PIRO score retained most of the original PIRO-CAP factors, including age under 6 months, comorbidities, SpO<sub>2</sub> 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).</p><p><strong>Conclusion: </strong>The Ch-online PIRO score shows promise as an effective prognostic tool for assessing the severity of CAP in young children.</p>\",\"PeriodicalId\":19932,\"journal\":{\"name\":\"Pediatric Pulmonology\",\"volume\":\"60 7\",\"pages\":\"e71199\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261875/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatric Pulmonology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ppul.71199\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Pulmonology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ppul.71199","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
Online Tool for Predicting Severe Cases of Childhood Community-Acquired Pneumonia Based on the PIRO Concept.
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.
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.
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