Research For Use Of PEWS In Evaluation The Condition Of Emergency Pediatric Patient

Objective: To explore the value of PEWS in PICU and emergency room for emergency pediatric patient.Method: Cases be hospitalized through emergency room in PICU from December 2014 to July 2015 were analyzed, the PEWS in emergency room and first time in PICU were recorded, ROC curve was used to analyze the efficacy of PEWS to diagnose the death. The sensitivity, specificity, PPV, NPV in different PEWS value were confirmed to explored the efficiency of PEWS. PEWS in different disease were analyzed to evaluate the scope of application. Correlation analysis between PEWS and PCIS, PRISM were made to clear the consistency of PEWS with the existing marking system.Result: 381 cases were included in our research, contained male cases 235(61.68%) and female cases 146(38.32%), the age range from 1 month to 14 years and 9 month. PEWS in PICU was 3.0(3.0, 4.0) points, which in emergency was 2.0(3.0,4.0) points. PEWS both in emergency room and PICU between death and survival group were significantly different(P<0.00). PEWS in nervous system, respiratory system and circulatory system was 3.0(3.0, 4.0) points, patient with other system the PEWS was 2.5(2.0,4.0) points, Difference between the two groups was significant(Z=5.70,P=0.00). PCIS in the patient included in the study was 90.0(86.0,96.0) points, which was significantly correlated with PEWS in PICU(r=0.51,P<0.01). Area under ROC curve of PEWS in PICU to diagnose the death was 0.77(0.70,0.84), in PEWS value of 4 the sensitivity and specificity were respectively 84.21% and 58.30%. The incidence of death were increased with higher PEWS in PICU. Area under ROC curve of PEWS in emergency room to diagnose the death was 0.72(0.66,0.80), in critical value of higher than 2 the sensitivity was 97.37% to diagnose death,Survival time between two groups divided by 3 point of PEWS were significantly different.Conclusion: PEWS can be used as an effective condition assessment tools for emergency pediatric patient. When the PEWS of patient in PICU greater than or equal to 4 point, forecasting a poor prognosis such as death may occur; Patient in emergency room whose PEWS were greater than 2 points should be close paid attention to and given priority treatment.