# Predictive value of serological markers and immune indicators combined with early warning scoring system for prognosis in pediatric acute respiratory infections

## TL;DR

This study shows that combining AVPU scores and blood markers helps predict which children with respiratory infections are at higher risk of poor outcomes.

## Contribution

The study demonstrates that AVPU scores and serological markers together improve prediction of prognosis in pediatric acute respiratory infections.

## Key findings

- Poor prognosis group had higher WBC, CRP, IL-6, and PCT levels compared to the good prognosis group.
- AVPU scores were significantly lower in children with poor outcomes.
- AVPU scores showed higher sensitivity and specificity than serological markers for predicting unfavorable outcomes.

## Abstract

The objective was to evaluate the combined utility of alertness-vigilance-pain-unresponsiveness (AVPU) scoring and serological factors in predicting outcomes for children with acute respiratory infections (ARIs) in the emergency department.

This retrospective cohort study with a case-control design included 100 children with ARIs admitted to a pediatric department from May 2022 to May 2024. Patients were divided into the good prognosis group (GPG) and the poor prognosis group (PPG) based on their outcomes. Clinical data, vital signs, alertness-vigilance-pain-unresponsiveness (AVPU) scores, serum inflammatory markers (SIMs), immunoglobulin levels, and immune cell counts were compared between the two groups.

The GPG had significantly lower WBC, CRP, IL-6, and PCT levels than the PPG. AVPU scores were substantially lower in the PPG. Pearson correlation analysis revealed no notable correlation between AVPU scores and SIMs. Receiver operating characteristic (ROC) curve analysis showed that AVPU scores had higher sensitivity and specificity for predicting unfavourable outcomes than SIMs.

AVPU scores and SIMs are valuable predictors of unfavourable outcomes in pediatric ARIs. Combined testing of AVPU scores and SIMs may improve predictive performance. These findings can inform early identification and timely intervention for children with ARIs at risk of unfavourable outcomes.