OBJECTIVES: Designed to detect early deterioration of the hospitalised child, paediatric early warning scores (PEWS) validity in the emergency department (ED) is less validated. We aimed to evaluate sensitivity and specificity of two commonly used PEWS (Brighton and COAST) in predicting hospital admission and, for the first time, significant illness. METHODS: Retrospective analysis of PEWS data for paediatric ED attendances at St Mary's Hospital, London, UK, in November 2012. Patients with missing data were excluded. Diagnoses were grouped: medical and surgical. To classify diagnoses as significant, established guidelines were used and, where not available, common agreement between three acute paediatricians. RESULTS: 1921 patients were analysed. There were 211 admissions (11%). 1630 attendances were medical (86%) and 273 (14%) surgical. Brighton and COAST PEWS performed similarly. hospital admission: PEWS of ≥3 was specific (93%) but poorly sensitive (32%). The area under the receiver operating curve (AUC) was low at 0.690. Significant illness: for medical illness, PEWS ≥3 was highly specific (96%) but poorly sensitive (44%). The AUC was 0.754 and 0.755 for Brighton and COAST PEWS, respectively. Both scores performed poorly for predicting significant surgical illness (AUC 0.642). PEWS ≥3 performed well in predicting significant respiratory illness: sensitivity 75%, specificity 91%. CONCLUSIONS: Both Brighton and COAST PEWS scores performed similarly. A score of ≥3 has good specificity but poor sensitivity for predicting hospital admission and significant illness. Therefore, a high PEWS should be taken seriously but a low score is poor at ruling out the requirement for admission or serious underlying illness. PEWS was better at detecting significant medical illness compared with detecting the need for admission. PEWS performed poorly in detecting significant surgical illness. PEWS may be particularly useful in evaluating respiratory illness in a paediatric ED. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
OBJECTIVES: Designed to detect early deterioration of the hospitalised child, paediatric early warning scores (PEWS) validity in the emergency department (ED) is less validated. We aimed to evaluate sensitivity and specificity of two commonly used PEWS (Brighton and COAST) in predicting hospital admission and, for the first time, significant illness. METHODS: Retrospective analysis of PEWS data for paediatric ED attendances at St Mary's Hospital, London, UK, in November 2012. Patients with missing data were excluded. Diagnoses were grouped: medical and surgical. To classify diagnoses as significant, established guidelines were used and, where not available, common agreement between three acute paediatricians. RESULTS: 1921 patients were analysed. There were 211 admissions (11%). 1630 attendances were medical (86%) and 273 (14%) surgical. Brighton and COAST PEWS performed similarly. hospital admission: PEWS of ≥3 was specific (93%) but poorly sensitive (32%). The area under the receiver operating curve (AUC) was low at 0.690. Significant illness: for medical illness, PEWS ≥3 was highly specific (96%) but poorly sensitive (44%). The AUC was 0.754 and 0.755 for Brighton and COAST PEWS, respectively. Both scores performed poorly for predicting significant surgical illness (AUC 0.642). PEWS ≥3 performed well in predicting significant respiratory illness: sensitivity 75%, specificity 91%. CONCLUSIONS: Both Brighton and COAST PEWS scores performed similarly. A score of ≥3 has good specificity but poor sensitivity for predicting hospital admission and significant illness. Therefore, a high PEWS should be taken seriously but a low score is poor at ruling out the requirement for admission or serious underlying illness. PEWS was better at detecting significant medical illness compared with detecting the need for admission. PEWS performed poorly in detecting significant surgical illness. PEWS may be particularly useful in evaluating respiratory illness in a paediatric ED. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Authors: Theresa McElroy; Erik N Swartz; Kasra Hassani; Sina Waibel; Yasmin Tuff; Catherine Marshall; Richard Chan; David Wensley; Maureen O'Donnell Journal: BMC Emerg Med Date: 2019-11-27
Authors: Dorine M Borensztajn; Nienke N Hagedoorn; Irene Rivero Calle; Ian K Maconochie; Ulrich von Both; Enitan D Carrol; Juan Emmanuel Dewez; Marieke Emonts; Michiel van der Flier; Ronald de Groot; Jethro Herberg; Benno Kohlmaier; Emma Lim; Federico Martinon-Torres; Daan Nieboer; Ruud G Nijman; Marko Pokorn; Franc Strle; Maria Tsolia; Clementien Vermont; Shunmay Yeung; Dace Zavadska; Werner Zenz; Michael Levin; Henriette A Moll Journal: PLoS One Date: 2021-01-07 Impact factor: 3.240
Authors: Asmaa Fady Sharif; Dina El Gameel El Gameel; Sanaa Abd El-Fatah Abdo; Elsayed Ibrahim Elgebally; Manar Maher Fayed Journal: Environ Sci Pollut Res Int Date: 2021-08-21 Impact factor: 4.223
Authors: Dorine M Borensztajn; Nienke N Hagedoorn; Enitan D Carrol; Ulrich von Both; Juan Emmanuel Dewez; Marieke Emonts; Michiel van der Flier; Ronald de Groot; Jethro Herberg; Benno Kohlmaier; Emma Lim; Ian K Maconochie; Federico Martinon-Torres; Daan Nieboer; Ruud G Nijman; Rianne Oostenbrink; Marko Pokorn; Irene Rivero Calle; Franc Strle; Maria Tsolia; Clementien L Vermont; Shunmay Yeung; Dace Zavadska; Werner Zenz; Michael Levin; Henriette A Moll Journal: Lancet Reg Health Eur Date: 2021-07-12