Duncan Heather, Hutchison James, Parshuram Christopher S
Paediatric Intensive Care Unit, Diana, Princess of Wales Children's Hospital, Steelhouse Lane, B4 6NH Birmingham, UK.
J Crit Care. 2006 Sep;21(3):271-8. doi: 10.1016/j.jcrc.2006.06.007.
We developed and performed the initial retrospective validation of a pediatric severity of illness score. The score is to preemptively identify hospitalized children who are likely to require resuscitation to treat cardiopulmonary arrest.
The Pediatric Early Warning System (PEWS) score was developed using expert opinion. The score generated contained 20 items, 16 of which were able to be retrospectively abstracted. Validation used a case-control study design in a Canadian university-affiliated pediatric hospital. Eligible patients were younger than 18 years, were admitted to a hospital ward, and had no level-of-care restrictions. Case patients had a code blue called to obtain immediate assistance for treatment of impending or actual cardiopulmonary arrest. Control patients had no code blue event and were not urgently admitted to the intensive care unit within 48 hours of study. A total of 128 controls and 87 cases were compared.
The PEWS score area under the receiver operating characteristic curve was 0.90. The sensitivity was 78% and the specificity was 95% at a score of 5.
Application of the score may have identified more than 3 quarters of code blue calls in our hospital with at least an hour's warning. After further refinement and validation, the PEWS score has great potential to increase the efficiency of care delivery and to improve the outcomes of care provided to hospitalized children.
我们开发并进行了一项儿科疾病严重程度评分的初步回顾性验证。该评分旨在预先识别可能需要进行复苏以治疗心肺骤停的住院儿童。
儿科早期预警系统（PEWS）评分是根据专家意见制定的。生成的评分包含20项，其中16项能够进行回顾性提取。验证采用加拿大一所大学附属医院的病例对照研究设计。符合条件的患者年龄小于18岁，入住医院病房，且无护理级别限制。病例患者呼叫了蓝色急救代码，以获得对即将发生或实际发生的心肺骤停进行治疗的即时援助。对照患者未发生蓝色急救代码事件，且在研究的48小时内未被紧急收治入重症监护病房。共比较了128例对照患者和87例病例患者。
PEWS评分的受试者工作特征曲线下面积为0.90。在评分为5分时，敏感性为78%，特异性为95%。
应用该评分可能在我院识别出超过四分之三的蓝色急救代码呼叫，且至少有一小时的预警时间。经过进一步完善和验证后，PEWS评分在提高护理效率和改善住院儿童护理结局方面具有巨大潜力。
