title: Development of a Global Respiratory Severity Score for Respiratory Syncytial Virus Infection in Infants.
abstract: Respiratory syncytial virus (RSV) infection in infants has recognizable clinical signs and symptoms. However, quantification of disease severity is difficult, and published scores remain problematic. Thus, as part of a RSV pathogenesis study, we developed a global respiratory severity score (GRSS) as a research tool for evaluating infants with primary RSV infection.
  
  
  
  Previously healthy infants <10 months of age with RSV infections representing the spectrum of disease severity were prospectively evaluated. Clinical signs and symptoms were collected at 3 time points from hospitalized infants and those seen in ambulatory settings. Data were also extracted from office, emergency department, and hospital records. An unbiased data-driven approach using factor analysis was used to develop a GRSS.
  
  
  
  A total of 139 infants (84 hospitalized and 55 nonhospitalized) were enrolled. Using hospitalization status as the output variable, 9 clinical variables were identified and weighted to produce a composite GRSS. The GRSS had an area under the receiver operator curve of 0.961. Construct validity was demonstrated via a significant correlation with length of stay (r = 0.586, P < .0001).
  
  
  
  Using routine clinical variables, we developed a severity score for infants with RSV infection that should be useful as an end point for investigation of disease pathogenesis and as an outcome measure for therapeutic interventions.
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Mary T
authors.initials: MT
authors.lastname: Caserta
authors.affiliation: Department of Biostatistics and Computational Biology, New York Influenza Center of Excellence at the University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Xing
authors.initials: X
authors.lastname: Qiu
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Brenda
authors.initials: B
authors.lastname: Tesini
authors.affiliation: Department of Biostatistics and Computational Biology, New York Influenza Center of Excellence at the University of Rochester Medical Center, Rochester, NY, USA.|Center for Vaccine Biology and Immunology, University of Rochester, Rochester, New York, USA.
authors.forename: Lu
authors.initials: L
authors.lastname: Wang
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Murphy
authors.affiliation: Department of Biostatistics and Computational Biology, New York Influenza Center of Excellence at the University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Corbett
authors.affiliation: Center for Vaccine Biology and Immunology, University of Rochester, Rochester, New York, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Topham
authors.affiliation: Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.|Department of Medicine, Rochester General Hospital, New York, USA.
authors.forename: Ann R
authors.initials: AR
authors.lastname: Falsey
authors.affiliation: Department of Biostatistics and Computational Biology, New York Influenza Center of Excellence at the University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Holden-Wiltse
authors.affiliation: Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.|Department of Medicine, Rochester General Hospital, New York, USA.
authors.forename: Edward E
authors.initials: EE
authors.lastname: Walsh
mesh_terms: D005260:Female; D005865:Gestational Age; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D016014:Linear Models; D008297:Male; D011446:Prospective Studies; D015203:Reproducibility of Results; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis* / Q000453:epidemiology*; D018113:Respiratory Syncytial Virus, Human; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: Lower respiratory tract infection; respiratory severity score; respiratory syncytial virus; upper respiratory tract infection