Pediatric Respiratory Severity Score (PRESS) for Respiratory Tract Infections in Children

Background: Respiratory tract infections are common diseases in children. It is crucial therefore to evaluate the severity of the condition during the initial bedside assessment in the emergency department so that further examinations and hospital treatment can be conducted as appropriate. However, there are few such scoring systems for acute respiratory infection in childhood. Objective: To evaluate a new simple bedside scoring system for the rapid assessment of pediatric respiratory infections in emergency settings. Methods: We established a respiratory scoring system, namely “Pediatric Respiratory Severity Score (PRESS)”, and examined its utility for assessing severity in 202 children who visited our hospital due to respiratory symptoms between January 2010 and November 2011. The PRESS assessed tachypnea, wheezing, retraction (accessory muscle use), SpO2, and feeding difficulties, with each component given a score of 0 or 1, and total scores were classified as mild (0–1), moderate (2–3), or severe (4–5). In addition, we performed RT-PCR techniques to detect respiratory viruses from nasal swabs and the detected viruses were evaluated in relation to severity. Results: According to the PRESS scores, the hospitalization rate was significantly higher in the moderate and severe groups than in the mild group. Oxygen therapy was longer in severe cases compared with other cases. There were no significant differences in the viral detection rate between the severity groups. Conclusion: The PRESS scoring system is useful for the initial assessment of respiratory tract infections in children to identify the need for hospitalization and further examination in emergency settings.