Validity of Different Pediatric Early Warning Scores in the Emergency Department
| Autor: | Henriëtte A. Moll, Nienke Seiger, Rianne Oostenbrink, Ian Maconochie |
|---|---|
| Přispěvatelé: | Pediatrics |
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Poison control Pediatrics law.invention Cohort Studies Patient Admission law medicine Humans Prospective Studies Prospective cohort study Child Receiver operating characteristic business.industry Infant Emergency department Early warning score Triage Intensive care unit Confidence interval Early Diagnosis ROC Curve Child Preschool Pediatrics Perinatology and Child Health Emergency medicine Female business Emergency Service Hospital |
| Zdroj: | Pediatrics, 132(4), E841-E850. American Academy of Pediatrics |
| ISSN: | 0031-4005 |
| DOI: | 10.1542/peds.2012-3594 |
| Popis: | OBJECTIVE: Pediatric early warning scores (PEWS) are being advocated for use in the emergency department (ED). The goal of this study was to compare the validity of different PEWS in a pediatric ED. METHODS: Ten different PEWS were evaluated in a large prospective cohort. We included children aged RESULTS: These PEWS were validated in 17 943 children. Two percent of these children were admitted to the ICU, and 16% were hospitalized. The areas under the ROC curves for predicting ICU admission, ranging from 0.60 (95% confidence interval [CI]: 0.57−0.62) to 0.82 (95% CI: 0.79–0.85), were moderate to good. The area under the ROC curves for predicting hospitalization was poor to moderate (range: 0.56 [95% CI: 0.55–0.58] to 0.68 [95% CI: 0.66–0.69]). The sensitivity and specificity derived from the ROC curves ranged widely for both ICU admission (sensitivity: 61.3%–94.4%; specificity: 25.2%–86.7%) and hospital admission (sensitivity: 36.4%–85.7%; specificity: 27.1%–90.5%). None of the PEWS had a high sensitivity as well as a high specificity. CONCLUSIONS: PEWS can be used to detect children presenting to the ED who are in need of an ICU admission. Scoring systems, wherein the parameters are summed to a numeric value, were better able to identify patients at risk than triggering systems, which need 1 positive parameter. |
| Databáze: | OpenAIRE |
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