September 11, 2013
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Early warning scores identified children in need of ICU care

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Pediatric early warning scores can be an important tool to help identify children who must be admitted to the ICU, according to recent study findings published in Pediatrics.

“Pediatric early warning scores are physiology-based scoring systems developed to identify patients admitted to inpatient pediatric wards at risk for clinical deterioration,” according to study background information. “A recent publication showed that early warning scores are needed to quickly identify critically ill patients in EDs so that treatment can be started without delay. Moreover, the use of the same system in the ED and inpatient wards allows continuity for patient assessment.”

The large prospective cohort study included 17,943 children younger than 16 years presenting to an ED and evaluated 10 pediatric early warning scores (PEWS).

Researchers found that 2% of participants were admitted to the ICU and 16% were hospitalized. Using ICU admission, sensitivity for different PEWS ranged from 61.3% to 94.4% and specificity ranged from 25.2% to 86.7%. Using hospitalization, researchers found that sensitivity ranged from 36.4% to 85.7% and specificity from 27.1% to 90.5%.

“[Pediatric early warning scores] are capable of identifying children in need of ICU admission,” researchers wrote. “Scoring systems, with parameters leading to a numeric value, were better able to identify patients at risk than triggering systems, which need one positive parameter.”

Disclosure: The study was funded in part by a grant from Europe Container Terminals.