Shafi Obeid M, Diego Rondon Juan D, Gulati Gagan
Department of Pediatrics, Flushing Hospital Medical Center, New York, USA.
Cureus. 2020 Nov 5;12(11):e11339. doi: 10.7759/cureus.11339.
Limited studies have evaluated the utility of scoring systems in the pediatric emergency department (PED) and no studies have evaluated their ability to predict hospital length of stay (LOS) and the usage of Observation units (OUs).
To evaluate the utility of the Pediatric Early Warning Score (PEWS) in predicting LOS in pediatric patients and thus anticipate admission to an OU versus the pediatric ward.
A retrospective study of pediatric inpatients (0 to 18 years) at an inner-city community hospital between January 2014 and December 2014. Patients with psychiatric illness, non-medical reasons for hospital stay, and those not discharged to 'home' were excluded. Demographic data, PEWS in the ED, and LOS for each patient were recorded and analyzed.
A total of 719 patients were analyzed. PEWS range was 0 to 8. The mean LOS was 56.8 hours for patients with PEWS 0-1 compared to 62.7 hours for patients with PEWS ≥2 (p=0.02). There was a significant difference in PEWS for LOS ≤24 and ≤36 hours in comparison to those with LOS >24 hours and >36 hours, respectively (p<0.001). Overall, the PEWS correlated with LOS (r=0.11, p=0.002). Age correlated inversely with LOS (r=-0.16, p<0.001), without correlation to PEWS (r=-0.002, p= 0.96).
PEWS correlated weakly with LOS. A statistically significant lower PEWS was observed for patients who had short stays (both ≤24 and ≤36 hours) in comparison to those requiring longer inpatient care. Therefore, the PEWS is a useful tool to predict LOS and aid ED physicians to determine disposition, although further prospective studies in centers with OUs would better characterize its ability to suggest admission to an OU compared to the wards.
对儿科急诊室（PED）评分系统效用的评估研究有限，且尚无研究评估其预测住院时长（LOS）及观察病房（OU）使用情况的能力。
评估儿科早期预警评分（PEWS）在预测儿科患者住院时长方面的效用，从而预测其入住观察病房而非儿科病房的可能性。
对一家市中心社区医院2014年1月至2014年12月期间的儿科住院患者（0至18岁）进行回顾性研究。排除患有精神疾病、因非医疗原因住院以及未出院回家的患者。记录并分析每位患者的人口统计学数据、急诊室的PEWS以及住院时长。
共分析了719例患者。PEWS范围为0至8。PEWS为0 - 1的患者平均住院时长为56.8小时，而PEWS≥2的患者为62.7小时（p = 0.02）。与住院时长>24小时和>36小时的患者相比，住院时长≤24小时和≤36小时的患者在PEWS方面存在显著差异（p<0.001）。总体而言，PEWS与住院时长相关（r = 0.11，p = 0.002）。年龄与住院时长呈负相关（r = -0.16，p<0.001），与PEWS无相关性（r = -0.002，p = 0.96）。
PEWS与住院时长的相关性较弱。与需要更长住院护理的患者相比，住院时间短（≤24小时和≤36小时）的患者PEWS在统计学上显著较低。因此，PEWS是预测住院时长并帮助急诊医生确定处置方式的有用工具，尽管在设有观察病房的中心进行进一步的前瞻性研究将能更好地描述其与建议入住观察病房而非病房相比的能力。
