Utility of PRESS score in predicting the outcomes of children admitted with respiratory distress: A prospective study

Abstract

Background: Respiratory distress in children must be promptly recognized and aggressively treated because they decompensate quickly leading to adverse outcomes. Objectives: To determine the outcomes of children admitted with respiratory distress based on PRESS score. Study Design: A prospective study which was done between September 2018 and March 2020. A total of 90 children of age group 1 month to 10 years with respiratory distress at the time of admission. Intervention: The PRESS scoring was done and outcomes measured which included use of Respiratory support [nasal cannula, high flow nasal cannula (HFNC), mechanical ventilation (MV)], duration of ICU and hospital stay. Results: Compared to moderate PRESS score, children with severe PRESS score had significantly more admission in PICU (91.30% vs 64.18%, P = 0.016); significantly more number of days of hospital stay (7 vs 5, P = 0.001); significantly more number of days of ICU stay (5 vs 3, P<.0001); significantly more median days of respiratory support (4 vs 3, P<.0001); significantly more use of respiratory support (67 vs 23patients, P < 0.0003) and more HFNC usage (73.91% vs 20.90%, P<.0001). However there was comparable requirement of mechanical ventilation between the two groups (8.7% vs 0%, P = 0.063). Conclusion: PRESS score can be a useful respiratory scoring system in triaging the children at the time of admission and in predicting the requirement of respiratory support and duration of hospital stay. It probably may serve as a useful tool at the community level to consider referral to an appropriate health facility in view of its simplicity.