Paediatric Early Warning Scoring

INTRODUCTION. There is still an urgent need for clinically based risk assessment systems for patient deterioration,
STUDY OBJECTIVE: to assess the discriminatory ability of the pediatric early warning scales PEWS and рqSOFA in predicting the duration of treatment in intensive care units
MATERIALS AND METHODS. Design: a prospective, observational, multicenter study. Inclusion criteria: children admitted to the ICU aged 1 month to 17 years. Exclusion criteria: children on mechanical ventilation and patients with shock. A total of 470 children were included in the study. The severity of the condition of all children admitted to the ICU was assessed within the first hour of treatment in the department using the PEWS and qSOFA scales. The end point is the duration of treatment in the intensive care unit (less than and more than 72 hours) depending on the body temperature on admission (below and above 380C). Demographic and clinical data are presented as median values with interquartile ranges of means and standard deviations. Continuous variables were compared using the Mann-Whitney U test. The discriminatory ability of the scales was determined by calculating the area under the ROC curve.
RESULTS. The predictive ability of the PEWS scale regarding the risk of longer treatment in the ICU is statistically significantly (p < 0.0001) higher compared to the pqSOFA assessment system. At the same time, its prognostic significance is low (AUG ROC less than 0.7). This pattern is also typical for febrile children.
CONCLUSIONS. The PEWS scale is a weak but informative predictor of the risk of organ dysfunction in a hospitalized child. A PEWS and pqSOFA score of two or more points is the basis for hospitalizing the child in the intensive care unit.