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Analysis Study Research Paper | Pediatrics and Child Health | India | Volume 12 Issue 9, September 2023 | Popularity: 5.6 / 10
Assessing the Efficacy of Pediatric Early Warning Score PEWS for Predicting Clinical Outcomes in Pediatric Emergency Care
Gem Raghav Prashanth R, Janani Sankar, Thilagavathi Duraisamy
Abstract: Background: Pediatric Early Warning Score (PEWS) is a simple tool in identifying children who are at risk of clinical deterioration and matching the severity of illness to appropriate level of care thereby allocating resources in the hospital. Objective: To determine the usefulness of Pediatric Early Warning Score in predicting clinical outcome in children brought to emergency and to explore the score characteristics for intensive care unit admission or clinical deterioration in admitted children. Methods: Study design - Prospective observational study. Setting - conducted in emergency room of, KanchiKamakoti CHILDS Trust Hospital during October - Nov 2019. Participants - 550 children aged 1 month to 18 years attending Emergency department during the study period. Intervention - Applying PEW Score. Outcome - Treated on Outpatient basis or requiring Hospitalisation including Intensive care. Results: 550 children with a mean age of 4.3 years were assessed.36 % managed on outpatient basis and 64 % required admission. As the PEW scores increased sensitivity decreased and specificity increased. Optimal cut off point for intensive care and hospitalization obtained from ROC are 5 and 2 respectively. PEW Score 5 is 83.1 % sensitive and 95.8 specific in predicting PICU admission. PEW Score 2 or more is 70.3 % sensitive and 91.8 specific in predicting hospitalisation. After considering Dengue patient parameters (PCV, warning signs) PEWS had 93.8% sensitivity and 86.1% specificity. Discussion: PEW Score was found to be a useful tool in predicting chances of clinical deterioration. As PEW scores increased, chances of getting admission in PICU increased. In the presence of comorbid conditions /associated diseases, chance of predicting the clinical deterioration increased. PEWS score of ?5 may be used to determine which patients are in critically ill condition requiring treatment in PICU. PEW score is not highly sensitive in predicting hospitalisation.
Keywords: Warning Signs, Intensive care, Hospitalisation, Dengue
Edition: Volume 12 Issue 9, September 2023
Pages: 617 - 620
DOI: https://www.doi.org/10.21275/SR23905225237
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