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Respiratory Index of Severity in Children (RISC) for HIV-Positive Child

Purpose: To determine the respiratory index of severity in a young HIV-positive child with a respiratory infection (RISC).

Description

Reed et al developed the respiratory indices of severity in children (RISC) with a respiratory infection in South Africa. One RISC is for HIV-negative children and one for HIV-infected children. The authors are from the Centers for Disease Control and Prevention (CDC), University of Witwatersrand, Emory University and the University of Washington in Seattle.


 

Patient selection: HIV-positive child < 24 months old in South Africa with respiratory infection

 

Parameters:

(1) most severe respiratory sign

(2) wheezing

(3) feeding refusal

(4) age in months

(5) HIV clinical stage

 

Parameter

Finding

Points

most severe respiratory sign

oxygen saturation < 90%

2

 

chest indrawing

1

 

neither

0

wheezing

no

0

 

yes

-1

feeding

normal

0

 

refusal

1

age in months

0 to 2 months

2

 

3 to 12 months

1

 

13 to 23 months

0

HIV clinical stage

N

0

 

A or B

1

 

C

2

 

total score =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: -1

• maximum score: 7

• The higher the score the greater the risk for mortality.

 

Score

Percent Mortality

-1 to 0

0%

1

2%

2

3%

3

7%

4

14%

5

27%

6 or 7

46%

 


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Specialty

Objective

ICD-10