The Validity of the Modified Tal Score and Wang Respiratory Score Instruments in Assessing the Severity of Respiratory System Disorders in Children

Devi, Ni Luh Putu Shinta; Wanda, Dessie; Nurhaeni, Nani

doi:10.1080/24694193.2019.1577921

Cited by 5 publications

(4 citation statements)

References 17 publications

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“…The sample size of our research was more significant than that of others used in studies on similar subjects, which generally ranged between 30 and 115 patients [12,[22][23][24], and which was slightly surpassed by the study of Marlais et al [25]. The age of our patients was similar to that of those who participated in other studies.…”

Section: Discussionmentioning

confidence: 55%

“…Another study conducted on admitted patients concluded that the modified Tal score presents greater validity, reliability, sensitivity, and specificity than the Wang score in estimating the severity of respiratory diseases in children [24]. Our study found that the Wang score [20], designed in 1992, is in concordance with the estimated clinical severity (0.783; p < 000.1), although lower than that provided by the modified Tal score, which is a finding that coincides with the findings of the Jakarta study.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Easy-to-Use Bronchiolitis Scores in the Post-COVID-19 Era—An Observational Study

Martín-Latorre,

Martínez-Campos,

Martín-González

et al. 2023

Children

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In the post-restrictions COVID-19 period, the incidence of bronchiolitis in infants has increased considerably. Several scores determine the degree of severity of the bronchiolitis episode, but few are clinician-friendly. The main aim of this research was to find the easy-to-use score that most accurately estimated the severity of patients’ infections according to their clinical situations and most accurately predicted the need for hospital admission. An observational cross-sectional study was performed in a reference pediatric hospital during the post-restrictions period of the COVID-19 pandemic (2021 and 2022). A comparison was made between the severity estimate provided by five international acute bronchiolitis scales and the clinical severity of the acute bronchiolitis episode. Three hundred and seventy-seven patients participated in the investigation, with a mean age of 5.68 months; 68.7% of the participants had a mild episode of bronchiolitis, 24.5% had a moderate episode, and 6.9% had a severe episode. The severity estimated by the Tal scale modified by McCallum showed a statistically significant correlation with the clinical severity established by clinical criteria (0.836; p < 0.001). It showed a high correlation with other international scores, such as the Wang score (0.820; p < 0.05) and the Wood–Downes–Ferrés score (0.936; p < 0.001). In the multivariate analysis, the constituent variables of the modified Tal score appeared in the final model that predicts the need for hospital admission. In the context of increased incidence after COVID-19, the Tal score modified by McCallum is an easy-to-use measuring instrument that presents an excellent concordance with the clinical severity estimated at first care contact. It also offers a more significant prediction of the need for hospital admission.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Comparison of Easy-to-Use Bronchiolitis Scores in the Post-COVID-19 Era—An Observational Study

Martín-Latorre,

Martínez-Campos,

Martín-González

et al. 2023

Children

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“…Circuits were single-patient use. The TAL respiratory score was obtained on enrollment to assess the severity of respiratory distress before initiation of respiratory support ( 30 ).…”

Section: Methodsmentioning

confidence: 99%

The novel LESS (low-cost entrainment syringe system) O2 blender for use in modified bubble CPAP circuits: a clinical study of safety

Wu,

Luch,

Slusher

et al. 2024

Front. Pediatr.

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BackgroundBubble continuous positive airway pressure (bCPAP) is used in resource-limited settings for children with respiratory distress. Low-cost modifications of bCPAP use 100% oxygen and may cause morbidity from oxygen toxicity. We sought to test a novel constructible low-cost entrainment syringe system (LESS) oxygen blender with low-cost modified bCPAP in a relevant clinical setting.MethodsWe conducted a clinical trial evaluating safety of the LESS O2 blender among hospitalized children under five years old in rural Cambodia evaluating the rate of clinical failure within one hour of initiation of the LESS O2 blender and monitoring for any other blender-related complications.FindingsThirty-two patients were included. The primary outcome (clinical failure) occurred in one patient (3.1%, 95% CI = 0.1–16.2%). Clinical failure was defined as intubation, death, transfer to another hospital, or two of the following: oxygen saturation <85% after 30 min of treatment; new signs of respiratory distress; or partial pressure of carbon dioxide ≥60 mmHg and pH <7.2 on a capillary blood gas. Secondary outcomes included average generated FiO2's with blender use, which were 59% and 52% when a 5 mm entrainment was used vs. a 10 mm entrainment port with 5–7 cm H2O of CPAP and 1–7 L/min (LPM) of flow; and adverse events including loss of CPAP bubbling (64% of all adverse events), frequency of repair or adjustment (44%), replacement (25%), and median time of respiratory support (44 h).InterpretationOverall the LESS O2 blender was safe for clinical use. The design could be modified for improved performance including less repair needs and improved nasal interface, which requires modification for the blender to function more consistently.

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“…The overcrowding of paediatric wards and emergency departments during the autumn-winter seasonal outbreaks is a recurring issue that presents serious organisational and resource-related problems. With the aim of identifying patients at higher risk of clinical deterioration and therefore facilitating resource optimisation, several clinical scoring systems have been proposed to predict the severity of bronchiolitis [3][4][5][6]. However, these scoring systems are limited in their accuracy.…”

Section: Introductionmentioning

confidence: 99%

Lung Ultrasound: A Useful Prognostic Tool in the Management of Bronchiolitis in the Emergency Department

Hernández-Villarroel,

Ruiz-García,

Manzanaro

et al. 2023

JPM

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Lung ultrasound, a non-invasive bedside technique for assessing paediatric patients with acute respiratory diseases, is becoming increasingly widespread. The aim of this prospective, observational cohort study was to evaluate the effectiveness of a clinical ultrasound score in assessing infants with acute bronchiolitis in the emergency department and its ability to accurately identify patients at a higher risk of clinical deterioration. Infants under 6 months of age with clinical symptoms compatible with acute bronchiolitis were enrolled and underwent clinical and lung ultrasound evaluations. The study included 50 patients, the median age of which was 2.2 months (IQR: 1–5), and the primary outcome was respiratory support. Infants requiring invasive or non-invasive ventilation showed higher scores (5 points [IQR: 3.5–5.5] vs. 2.5 [IQR: 1.5–4]). The outcome had an AUC of 0.85 (95%CI: 0.7–0.98), with a sensitivity of 87%, specificity of 64%, and negative predictive value of 96.4% for a score <3.5 points. Children who scored ≥3.5 points were more likely to require respiratory support within the next 24 h (estimated event-free survival of 82.9% compared to 100%, log-rank test p-value = 0.02). The results suggest that integrating lung ultrasound findings into clinical scores when evaluating infants with acute bronchiolitis could be a promising tool for improving prognosis.

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The Validity of the Modified Tal Score and Wang Respiratory Score Instruments in Assessing the Severity of Respiratory System Disorders in Children

Cited by 5 publications

References 17 publications

Comparison of Easy-to-Use Bronchiolitis Scores in the Post-COVID-19 Era—An Observational Study

Comparison of Easy-to-Use Bronchiolitis Scores in the Post-COVID-19 Era—An Observational Study

The novel LESS (low-cost entrainment syringe system) O2 blender for use in modified bubble CPAP circuits: a clinical study of safety

Lung Ultrasound: A Useful Prognostic Tool in the Management of Bronchiolitis in the Emergency Department

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