Stratifying Severity in Children with Seasonal Respiratory Viral Infections: A Vital Sign–Derived Risk Gradient in the Emergency Department
Keywords:
pediatrics, influenza, RSV, triage, severity, vital-signsAbstract
Seasonal respiratory viral infections place a recurrent burden on pediatric emergency departments (EDs), yet robust, bedside tools to stratify clinical severity remain limited. This study aimed to evaluate how patterns of admission vital sign abnormalities differ across severity levels in children with seasonal respiratory viral infections and to quantify these differences using simple statistics and bar graph comparisons. We conducted a cross-sectional analysis of 150 children aged 1 month to 15 years admitted from a tertiary pediatric ED during peak viral seasons with clinical syndromes consistent with acute respiratory infection or influenza-like illness. Children were categorized as mild, moderate or severe based on oxygen and ventilatory support requirements and need for intensive care. At triage, temperature, heart rate, respiratory rate, blood pressure and oxygen saturation were recorded and classified as normal or abnormal according to age-adjusted thresholds. Overall, fever was present in 80.0%, tachycardia in 60.7%, tachypnea in 58.0%, hypoxia (SpO₂ < 92%) in 30.0% and hypotension in 10.7% of patients.
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