Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Department of Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
J Hosp Med. 2020 Nov;15(11):673-676. doi: 10.12788/jhm.3515.
Critical deterioration events (CDEs) and emergency transfers (ETs) are two proximal measures to cardiopulmonary arrest, and both aim to evaluate how systems recognize and respond to clinical deterioration in children. This retrospective observational study sought to (1) characterize CDEs and ETs by timing, overlap, and intervention category, and (2) evaluate the performance of the watcher identification system and the pediatric early warning score (PEWS) to identify patients who experience these events. A total of 359 CDEs and 88 ETs occurred during the study period. Respiratory events were most common and accounted for 80.5% of CDEs and 47.7% of ETs. A narrow majority of patients were identified as watchers (55.4% of CDEs and 51.1% of ETs). In total, 85.5% of CDEs and 87.5% of ETs were identified as watchers, elevated PEWS, or both. Opportunities exist for improved escalation plans for high-risk patients to prevent the need for emergent intervention.
危急恶化事件（CDEs）和紧急转科（ETs）是心肺骤停的两个近测指标，二者都旨在评估系统如何识别和应对儿童的临床恶化情况。这项回顾性观察性研究旨在：（1）通过时间、重叠和干预类别来描述 CDEs 和 ETs；（2）评估观察器识别系统和儿科预警评分（PEWS）识别发生这些事件的患者的性能。研究期间共发生 359 次 CDEs 和 88 次 ETs。呼吸事件最为常见，占 CDEs 的 80.5%和 ETs 的 47.7%。大多数患者被确定为观察器（CDEs 的 55.4%和 ETs 的 51.1%）。总的来说，85.5%的 CDEs 和 87.5%的 ETs 被确定为观察器、升高的 PEWS 或两者兼有。有机会为高危患者制定改进的升级计划，以防止紧急干预的需要。
