Study of acute illness observation scale and serum procalcitonin levels in community-acquired pneumonia in children aged 2 months to 59 months.

Abstract

Introduction Community-acquired pneumonia (CAP) poses a major health challenge worldwide, with notable variations in incidence, causative pathogens, and outcomes across different regions and populations. In India, CAP accounts for about 23% of the global burden, with an estimated 4 million cases annually, 20% requiring hospitalization. The annual incidence ranges from 5 to 11/ 1,000 individuals, with varying mortality rates based on the setting: Neuroendocrine cells found in the thyroid, lung, and intestine typically produce procalcitonin (PCT), a protein precursor to the hormone calcitonin. As part of the innate immune system's pro-inflammatory response, parenchymal cells release PCT, a precursor peptide of calcitonin, which is detectable 4 hours after endotoxin stimulation—much sooner than CRP. Procalcitonin (PCT) has been established as a marker of bacterial infection to differentiate septic from other infections in pediatric patients. PCT is less than 0.5 ng/ml in healthy people and rises quickly within three hours of the bacterial infection developing. Within six to twelve hours, PCT levels reach their peak and stay elevated until the infection subsides due to either antibiotic therapy or the host's immunological response. To the best of our knowledge, there has not been a comparable study conducted on a pediatric population in India, which is why this study was selected. Objectives 1. To evaluate the child according to the parameters of the Acute Illness Observation Scale (AIOS) and score the condition of the child. 2. To measure the Serum Procalcitonin levels and correlate the values with the AIOS score. Materials And Methods It’s a Prospective Cohort Study conducted in Pediatric ICU, Shri. B. M. Patil Medical College, Hospital & Research Centre, BLDE (DU), Vijayapura, Karnataka with a duration of 1.5 years with a sample size of 51 and Children between the ages of two and fifty-nine months who exhibit fever, cough, and hurried breathing were included in the study. Statistical Analysis Data collected was entered into a Microsoft Excel spreadsheet and analyzed using SPSS software. The results were expressed as Mean (Median) ± Standard Deviation (SD), Interquartile range (IQR), Counts and percentages. Graphical Representation: Findings were illustrated using appropriate diagrams and charts. Results Out of 51 children, the majority were in the age group of 12 months -5 years i.e., 52.9% (n 27) followed by 47.1% (n-24) in the age group of Conclusion Both the Acute Illness Observation Scale (AIOS) along Serum Procalcitonin levels demonstrate a strong ability to detect the severity level and determine clinical outcomes in children with community-acquired pneumonia. Hence, we conclude that combining the AIOS scoring system along with Serum Procalcitonin levels has a better clinical decision. The mortality risk increases when patients have high AIOS scores and their procalcitonin levels remain elevated.