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 aiuthors 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-negative child < 24 months old in South Africa with respiratory infection
Parameters:
(1) most severe respiratory sign
(2) wheezing
(3) feeding refusal
(4) z score for weight for age (from weight for age graphic)
Parameter
Finding
Points
most severe respiratory sign
oxygen saturation < 90%
3
chest indrawing
2
neither
0
wheezing
no
0
yes
-2
feeding
normal
0
refusal
1
weight for age
z-score <= -3.00
2
z score -2.99 to -2.00
1
z score > - 2.00
0
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: -2
• maximum score: 6
• The higher the score the greater the risk for mortality.
Score
Percent Mortality
-2 to 1
0%
2
< 1%
3
2%
4
5%
5
11%
6
14%
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