Development and an initial validation of the Responses to Illness Severity Quantification (RISQ) score for severely malnourished children

• Published in: Acta Paediatrica 2022-09, Vol.111 (9), p.1752-1763
• Main Authors: Dale, Nancy M., Ashir, Garba Mohammed, Maryah, Lawan Bukar, Shepherd, Susan, Tomlinson, George, Briend, André, Zlotkin, Stanley, Parshuram, Christopher
• Format: Article
• Language: English
• Subjects: Child; Child Nutrition Disorders - diagnosis; Children; Edema; Heart rate; Humans; Infant; Malnutrition; Mortality; Nigeria; Patient Acuity; Prospective Studies; Respiration; score; Severe Acute Malnutrition - diagnosis; severity of illness; Severity of Illness Index
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1111/apa.16410

Aim To develop and perform an initial validation of a score to measure the severity of illness in hospitalised children with severe acute malnutrition (SAM). Methods A prospective study enrolled SAM children aged 6–59 months hospitalised in Borno State, Nigeria. Candidate items associated with inpatient mortality were combined and evaluated as candidate scores. Clinical and statistical methods were used to identify a preferred score. Results The 513 children enrolled had a mean age of 15.6 months of whom 48 (9%) died. Seven of the 10 evaluated items were significantly associated with mortality. Five different candidate scores were tested. The final score, Responses to Illness Severity Quantification (RISQ), included seven items: heart rate, respiratory rate, respiratory effort, oxygen saturation, oxygen delivery, temperature and level of consciousness. The mean RISQ score on admission was 2.6 in hospital survivors and 7.3 for children dying