Abstract
Objective
To explore the value of pediatric early warning scoring system (PEWS) in an emergency
observation room in China.
Methods
The children who had been admitted consecutively to the emergency observation room
from Jan, 2019 to Aug, 2020 were selected. Three most important time-points including
the first value (admission value), the highest value during the observation (highest
value), and final value (discharge value) of Brighton Pediatric Early Warning Score
(PEWS) was evaluated in all patients.
Results
4717 patients were included. They were categorized into 3 groups, namely, discharged
group (G1, n = 2320), specialized ward group (G2, n = 2128), and ICU group (G3, n = 269). The different PEWS values of admission value, highest value, and discharge
value were significantly different among the 3 groups (P<0.001). Highest value of G1 and G2 were significantly lower than that of G3 (P<0.001).
AUROC curves of different PEWS values were used to predict the possibility of PICU
admission and PICU mortality within 24 h of admission, and the values were 0.698,
0.878, 0.974 and 0.709, 0.883, 0.951, respectively. The cutoff values for PICU admission
of 3 different PEWS values were 2.5 (sensitivity 0.635, specificity 0.699), 3.5 (sensitivity
0.817, specificity 0.9), 3.5 (sensitivity 0.837, specificity 0.985). The cutoff values
for PICU mortality of 3 different PEWS values were 4 (sensitivity 0.625, specificity
0.799), 4.5 (sensitivity 0.722, specificity 0.79), 4.5 (sensitivity 0.883, specificity
0.987). The discharge value had the strongest prediction ability.
Conclusions
PEWS can be used for early identification and warning of critically ill children.
Keywords
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Article info
Publication history
Published online: May 18, 2022
Accepted:
May 10,
2022
Received in revised form:
May 10,
2022
Received:
October 27,
2021
Identification
Copyright
© 2022 Published by Elsevier Inc.
