Use of Modified Respiratory Distress Assessment Instrument (RDAI) Score to Determine Short-Term Morbidity in Children with Acute Lower Respiratory Tract Infections (ALRI)

Objective: To determine the clinical utility of modified Respiratory Distress Assessment Instrument (RDAI) score in predicting the short-term outcome of acute lower respiratory tract infections (ALRI) in children two months to two years of age. Study design: Descriptive study. Setting: Department of Pediatrics, Services Hospital, Lahore. Duration: From August 2008 to March 2009. Subjects and methods: One hundred and forty cases of ALRI, from 2 months to 2 years of age were selected. ALRI was diagnosed on the basis of fast breathing and lower chest indrawing. Modified RDAI scoring was applied at the time of admission or soon after, before instituting treatment. Results: Mean age of the patients was observed 7.94 +/- 6.4 months. Total 99.3% patients were discharged and among those 77.8% were discharged in 72 hours of admission in hospital while remaining 22.1% patients were discharged after 72 hours of hospital stay and there was only one expiry amounting to 0.7% cases. 39.3% children with mild respiratory distress on modified RADI stayed in the hospital for < 24 hours, 0.7% for 25 to 72 hours and 4.3% for > 72 hours as compared to children with moderated respiratory distress among whom19.3% stayed for > 24 hours, 17.9% for 25 to 72 hours and 15.7% for > 72 hours. Conclusion: It is concluded that modified RDAI score may be used to determine the severity of ALRI and mild to moderate patients may be managed at out-patient-basis.