Development of a Clinical Risk Assessment Score for Respiratory Distress Due to Respiratory Infections in Early Infancy
Background/Objectives: Neonatal and infant respiratory distress carries high morbidity, and severity can vary with gestational maturity and perinatal factors. Early risk stratification may improve outcomes, but existing assessment tools do not fully address age-related risk differences. We aimed to...
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2025-06-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/12/6/746 |
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| author | Cristina Elena Singer Cristina Popescu Diana-Maria Trasca Renata-Maria Varut Rebecca-Cristiana Serban Jaqueline Abdul-Razzak Virginia-Maria Radulescu |
| author_facet | Cristina Elena Singer Cristina Popescu Diana-Maria Trasca Renata-Maria Varut Rebecca-Cristiana Serban Jaqueline Abdul-Razzak Virginia-Maria Radulescu |
| author_sort | Cristina Elena Singer |
| collection | DOAJ |
| description | Background/Objectives: Neonatal and infant respiratory distress carries high morbidity, and severity can vary with gestational maturity and perinatal factors. Early risk stratification may improve outcomes, but existing assessment tools do not fully address age-related risk differences. We aimed to develop and validate a Neonatal Clinical Risk Assessment Score (N-CRAS) for predicting severity in neonates and young infants with respiratory distress due to respiratory infection. Methods: This pilot score was applied exclusively to a cohort of forty neonates and young infants with respiratory distress secondary to infectious causes, as defined by clinical and laboratory parameters. Clinical variables (gestational age, delivery mode, birth weight category, and APGAR score) were recorded and analyzed for associations with illness severity. We developed the N-CRAS (0–5 points) encompassing five indicators of severe illness (respiratory infection, metabolic disorder, need for symptomatic treatment, mechanical ventilation, and intubation), each contributing 1 point. Patients were stratified as low (0–1), moderate (2–3), or high (4–5) risk. Chi-square tests and Spearman correlation assessed associations, and an ROC curve evaluated the score’s predictive performance for intubation. Results: No individual perinatal factor was significantly associated with respiratory illness severity. The N-CRAS increased with infant age (<i>p</i> < 0.05), indicating older infants tended to have more severe disease. All study infants who required intubation fell into the high-risk category (score ≥ 4). The N-CRAS demonstrated excellent discrimination for predicting intubation (ROC area under the curve = 1.00). Conclusions: In this pilot study, the N-CRAS demonstrated a strong correlation with clinical severity and successfully identified all infants who required intubation. However, given the small cohort size and limited number of severe cases, these findings should be interpreted cautiously. Further external validation in larger and more diverse neonatal populations is essential to confirm its predictive utility. |
| format | Article |
| id | doaj-art-5be0675892fe440db0954e4c62742bbe |
| institution | Kabale University |
| issn | 2227-9067 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj-art-5be0675892fe440db0954e4c62742bbe2025-08-20T03:26:21ZengMDPI AGChildren2227-90672025-06-0112674610.3390/children12060746Development of a Clinical Risk Assessment Score for Respiratory Distress Due to Respiratory Infections in Early InfancyCristina Elena Singer0Cristina Popescu1Diana-Maria Trasca2Renata-Maria Varut3Rebecca-Cristiana Serban4Jaqueline Abdul-Razzak5Virginia-Maria Radulescu6Department of Mother and Baby, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Anatomy, University of Medicine and Pharmacy, Discipline of Anatomy, 200349 Craiova, RomaniaDepartment of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaResearch Methodology Department, Faculty of Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaCellular and Molecular Biology, University of Medicine and Pharmacy, Discipline of Anatomy, 200349 Craiova, RomaniaDepartment of Mother and Baby, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaBackground/Objectives: Neonatal and infant respiratory distress carries high morbidity, and severity can vary with gestational maturity and perinatal factors. Early risk stratification may improve outcomes, but existing assessment tools do not fully address age-related risk differences. We aimed to develop and validate a Neonatal Clinical Risk Assessment Score (N-CRAS) for predicting severity in neonates and young infants with respiratory distress due to respiratory infection. Methods: This pilot score was applied exclusively to a cohort of forty neonates and young infants with respiratory distress secondary to infectious causes, as defined by clinical and laboratory parameters. Clinical variables (gestational age, delivery mode, birth weight category, and APGAR score) were recorded and analyzed for associations with illness severity. We developed the N-CRAS (0–5 points) encompassing five indicators of severe illness (respiratory infection, metabolic disorder, need for symptomatic treatment, mechanical ventilation, and intubation), each contributing 1 point. Patients were stratified as low (0–1), moderate (2–3), or high (4–5) risk. Chi-square tests and Spearman correlation assessed associations, and an ROC curve evaluated the score’s predictive performance for intubation. Results: No individual perinatal factor was significantly associated with respiratory illness severity. The N-CRAS increased with infant age (<i>p</i> < 0.05), indicating older infants tended to have more severe disease. All study infants who required intubation fell into the high-risk category (score ≥ 4). The N-CRAS demonstrated excellent discrimination for predicting intubation (ROC area under the curve = 1.00). Conclusions: In this pilot study, the N-CRAS demonstrated a strong correlation with clinical severity and successfully identified all infants who required intubation. However, given the small cohort size and limited number of severe cases, these findings should be interpreted cautiously. Further external validation in larger and more diverse neonatal populations is essential to confirm its predictive utility.https://www.mdpi.com/2227-9067/12/6/746neonatal respiratory distressrisk stratificationN-CRASprematurityclinical severity prediction |
| spellingShingle | Cristina Elena Singer Cristina Popescu Diana-Maria Trasca Renata-Maria Varut Rebecca-Cristiana Serban Jaqueline Abdul-Razzak Virginia-Maria Radulescu Development of a Clinical Risk Assessment Score for Respiratory Distress Due to Respiratory Infections in Early Infancy Children neonatal respiratory distress risk stratification N-CRAS prematurity clinical severity prediction |
| title | Development of a Clinical Risk Assessment Score for Respiratory Distress Due to Respiratory Infections in Early Infancy |
| title_full | Development of a Clinical Risk Assessment Score for Respiratory Distress Due to Respiratory Infections in Early Infancy |
| title_fullStr | Development of a Clinical Risk Assessment Score for Respiratory Distress Due to Respiratory Infections in Early Infancy |
| title_full_unstemmed | Development of a Clinical Risk Assessment Score for Respiratory Distress Due to Respiratory Infections in Early Infancy |
| title_short | Development of a Clinical Risk Assessment Score for Respiratory Distress Due to Respiratory Infections in Early Infancy |
| title_sort | development of a clinical risk assessment score for respiratory distress due to respiratory infections in early infancy |
| topic | neonatal respiratory distress risk stratification N-CRAS prematurity clinical severity prediction |
| url | https://www.mdpi.com/2227-9067/12/6/746 |
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