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Prospective cohort study to test the predictability of the Cardiff and Vale paediatric early warning system

Edwards, Elizabeth Dawn, Powell, Colin Victor Eric, Mason, Brendan and Oliver, Alison 2009. Prospective cohort study to test the predictability of the Cardiff and Vale paediatric early warning system. Archives of Disease in Childhood 94 (8) , pp. 602-606. 10.1136/adc.2008.142026

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Abstract

Objective: To develop and test the predictability of a paediatric early warning score to identify children at risk of developing critical illness. Design: Prospective cohort study. Setting: Admissions to all paediatric wards at the University Hospital of Wales. Outcome measures: Respiratory arrest, cardiac arrest, paediatric high dependency unit admission, paediatric intensive care unit admission, and death. Results: Data were collected on 1000 patients. A single abnormal observation determined by the Cardiff and Vale Paediatric Early Warning System (C&VPEWS) had a 89.0% sensitivity (95% CI, 80.5 - 94.1), 63.9% specificity (95% CI,63.8 - 63.9), 2.2% positive predictive value (95% CI, 2.0 – 2.3) and a 99.8% negative predictive value (95% CI, 99.7 - 99.9) for identifying children who subsequently had an adverse outcome. The area under the receiver operating characteristic curve for the C&VPEWS score was 0.86 (95% CI, 0.82 – 0.91). Conclusion: Identifying children likely to develop critical illness can be difficult. The assessment tool developed from the Advanced Paediatric Life Support guidelines on identifying sick children appears to be sensitive but not specific. If the C&VPEWS was used as a trigger to activate a rapid response team (RRT) to assess the child, the majority of calls would be unnecessary.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Publisher: BMJ Publishing Group
ISSN: 0003-9888
Last Modified: 10 Oct 2017 14:15
URI: http://orca-mwe.cf.ac.uk/id/eprint/27572

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