Pediatric early warning score as a prognostic indicator in critically ill children - a prospective study

Abstract

Introduction: The early identification of patients at risk of clinical deterioration and matching the severity of illness to the appropriate level of care are integral components of high-quality medical care. Aconcept for identifying early signs of deterioration is the use of an early warning score tool that combines clinical parameters into a single score. The rationale for using early warning scoring systems is that signs of deterioration have been shown to be present and detectable in many patients several hours before undergoing a serious life-threatening event.

Methods: A prospective observational study was conducted in the Department of Pediatrics G.M.C. Bhopal, M.P. A total of 257 patients (1 month – 14 years) withan acute problem, who were admitted in PICU,were included. At 0-hourof admission Pediatric Early Warning Score (PEWS) was calculated in different domains - behavioural, respiratory and the cardiovascular. Then sensitivity and specificity were calculated fora specific score.

Results: Specificity was 92.0% at PEWS Score of 3 and declines to 54.55% at PEWS Score of 7. Sensitivity was 31.28% at PEWS score of 3 and rises to 99.05 at PEWS Score of 7.

Conclusion: PEWS is highly sensitive and specific in predicting the mortality, differentially against the various PEWS scores.