{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T16:42:19Z","timestamp":1788280939320,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pneumonia remains a leading cause of mortality among children under 5 years of age. This study aimed to compare existing prognostic scoring systems and identify the most effective tool for assessing outcomes in children with community\u2010acquired pneumonia (CAP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Predisposition, Insult, Response, and Organ Dysfunction score for CAP (PIRO\u2010CAP) was modified to create the Ch\u2010online PIRO score based on a comprehensive cohort study. This new scoring system was validated in a cohort of 75,965 children under the age of 5 years with CAP, treated at the Children's Hospital of Chongqing Medical University between 2016 and 2021. Effectiveness in predicting severe cases was then compared against the Pediatric Critical Illness Score (PCIS), Pneumonia Etiology Research for Child Health (PERCH) score, and PIRO\u2010CAP score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The Ch\u2010online PIRO score retained most of the original PIRO\u2010CAP factors, including age under 6 months, comorbidities, SpO\n                      <jats:sub>2<\/jats:sub>\n                      below 90%, multilobar or complicated pneumonia, kidney or liver dysfunction, and respiratory failure, but replaced hypotension and bacteremia with delayed capillary refill time (&gt;\u20093\u2009s) and procalcitonin &gt;\u20090.5\u2009ng\/mL. When predicting severe CAP cases, the Ch\u2010online PIRO score demonstrated superior discriminatory performance (AUC\u2009=\u20090.85, 95% CI: 0.85\u20130.86) compared to the PCIS (AUC\u2009=\u20090.67, 95% CI: 0.66\u20130.69), PERCH score (AUC\u2009=\u20090.64, 95% CI: 0.64\u20130.65), and PIRO\u2010CAP score (AUC\u2009=\u20090.68, 95% CI: 0.64\u20130.71).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The Ch\u2010online PIRO score shows promise as an effective prognostic tool for assessing the severity of CAP in young children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71199","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T11:17:18Z","timestamp":1752578238000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Online Tool for Predicting Severe Cases of Childhood Community\u2010Acquired Pneumonia Based on the PIRO Concept"],"prefix":"10.1002","volume":"60","author":[{"given":"Xin","family":"Long","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders Chongqing China"},{"name":"Chongqing Key Laboratory of Child Rare Disease in Infection and Immunity Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanling","family":"Li","sequence":"additional","affiliation":[{"name":"Chongqing Key Laboratory of Child Rare Disease in Infection and Immunity Chongqing China"},{"name":"Department of Respiratory Medicine Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child 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