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RMJ. 2026; 51(2): 472-475


Diagnosing and predicting pediatric pneumonia severity by using Respiratory Index of Severity in Children (RISC) Scoring System

Kulsoom Abdul Sattar, Muhammad Rafique, Zainab Khalid, Saima Mehmood, Abdul Salam, Malik Sohail Danish.


Abstract
Objective: To evaluate the Respiratory Index of Severity in Children (RISC) scoring system in the diagnosis and assessment of the severity of pneumonia in children, taking chest X-rays as the gold standard.
Methodology: This cross-sectional study was performed at the Pediatric Department of DR. Ruth KM PFAU, Civil Hospital, Karachi, Pakistan, from October 2024 to March 2025. The study included 145 children aged 1 month to 5 years, with a clinical diagnosis of pneumonia. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy was calculated for RISC score ≥3, taking a chest X-ray score of ≥3 as a reference point for the diagnosis of pneumonia. A p-value <0.05 marked significance.
Results: Out of 145 children, 55.2% were female, with a median (IQR) age of 30.00 (22.00–39.00) months. Urban residence was noted in 74.5%, and 31.7% were fully vaccinated. RISC scores showed a modest but significant positive correlation with chest X-ray scores (Spearman’s coefficient=0.294, p<0.001). At a RISC threshold ≥3, sensitivity, specificity, PPV, NPV, and diagnostic accuracy were 88.0%, 31.7%, 21.2%, 92.7%, and 41.4%, respectively. The ROC analysis yielded an AUC of 0.696 (95% CI:0.574–0.817, p=0.002), indicating moderate diagnostic utility.
Conclusion: The RISC scoring system, with a threshold of ≥3, offers a sensitive and moderately accurate method for identifying pediatric pneumonia, with potential utility in reducing diagnostic delays and enhancing triage in low-resource settings.

Key words: Children, pneumonia, Respiratory Index of Severity in Children, vaccinated, x-ray.


 
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How to Cite this Article
Pubmed Style

Sattar KA, Rafique M, Khalid Z, Mehmood S, Salam A, Danish MS. Diagnosing and predicting pediatric pneumonia severity by using Respiratory Index of Severity in Children (RISC) Scoring System. RMJ. 2026; 51(2): 472-475.

Web Style

Sattar KA, Rafique M, Khalid Z, Mehmood S, Salam A, Danish MS. Diagnosing and predicting pediatric pneumonia severity by using Respiratory Index of Severity in Children (RISC) Scoring System. https://www.rmj.org.pk/?mno=281992 [Access: May 26, 2026].

AMA (American Medical Association) Style

Sattar KA, Rafique M, Khalid Z, Mehmood S, Salam A, Danish MS. Diagnosing and predicting pediatric pneumonia severity by using Respiratory Index of Severity in Children (RISC) Scoring System. RMJ. 2026; 51(2): 472-475.


Vancouver/ICMJE Style

Sattar KA, Rafique M, Khalid Z, Mehmood S, Salam A, Danish MS. Diagnosing and predicting pediatric pneumonia severity by using Respiratory Index of Severity in Children (RISC) Scoring System. RMJ. (2026), [cited May 26, 2026]; 51(2): 472-475.


Harvard Style

Sattar, K. A., Rafique, . M., Khalid, . Z., Mehmood, . S., Salam, . A. & Danish, . M. S. (2026) Diagnosing and predicting pediatric pneumonia severity by using Respiratory Index of Severity in Children (RISC) Scoring System. RMJ, 51 (2), 472-475.


Turabian Style

Sattar, Kulsoom Abdul, Muhammad Rafique, Zainab Khalid, Saima Mehmood, Abdul Salam, and Malik Sohail Danish. 2026. Diagnosing and predicting pediatric pneumonia severity by using Respiratory Index of Severity in Children (RISC) Scoring System. Rawal Medical Journal, 51 (2), 472-475.


Chicago Style

Sattar, Kulsoom Abdul, Muhammad Rafique, Zainab Khalid, Saima Mehmood, Abdul Salam, and Malik Sohail Danish. "Diagnosing and predicting pediatric pneumonia severity by using Respiratory Index of Severity in Children (RISC) Scoring System." Rawal Medical Journal 51 (2026), 472-475.


MLA (The Modern Language Association) Style

Sattar, Kulsoom Abdul, Muhammad Rafique, Zainab Khalid, Saima Mehmood, Abdul Salam, and Malik Sohail Danish. "Diagnosing and predicting pediatric pneumonia severity by using Respiratory Index of Severity in Children (RISC) Scoring System." Rawal Medical Journal 51.2 (2026), 472-475. Print.


APA (American Psychological Association) Style

Sattar, K. A., Rafique, . M., Khalid, . Z., Mehmood, . S., Salam, . A. & Danish, . M. S. (2026) Diagnosing and predicting pediatric pneumonia severity by using Respiratory Index of Severity in Children (RISC) Scoring System. Rawal Medical Journal, 51 (2), 472-475.


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