| کلمات کلیدی | PEWS, Revised PEWS, in-hospital mortality prediction, Shock Index, peripheral oxygen saturation, children, ambulance, Emergency Department, hospital |
| خلاصه مقاله | Introduction: One of the major challenges in pediatric care is predicting in-hospital mortality. The Pediatric Early Warning Score (PEWS), a tool used to detect patients at risk of mortality or clinical deterioration, is widely used. But its accuracy is not always enough for identifying these risks in some situations. In an effort to overcome this shortcoming, parameters such as peripheral oxygen saturation (SpO₂) and age-adjusted Shock Index were included in the Revised Pediatric Early Warning Score (Revised PEWS). The goal of this study was to compare PEWS and Revised PEWS in predicting in-hospital mortality in children aged 1 to 17 years when transported to the Emergency Department (ED) by ambulance.
Methods: This cross-sectional study was conducted in 1402 (2023) using data of 2153 children aged 1 to 17 years who had been transferred by ambulance to the Emergency Department of Mardani Azar Children’s Hospital in Tabriz, Iran. Patients with certain conditions (e.g., pregnant adolescents) were excluded. The data consisted of vital signs (heart rate, respiratory rate, blood pressure, temperature, SpO₂ and Shock Index). For each patient, PEWS and Revised PEWS scores were calculated and compared.
Results: Revised PEWS was more accurate than PEWS in predicting in-hospital mortality. Revised PEWS AUROC: 0.87, PEWS AUROC: 0.80. New parameters include Shock Index and SpO₂, which, when added, greatly increased sensitivity and predictive accuracy for mortality.
Conclusion: Compared to PEWS, the Revised PEWS, which adds more parameters such as SpO₂ and Shock Index, was more accurate in predicting mortality during admission. The scoring system can provide a better strategy for predicting children who may die in paediatric emergency room. |