The Application Value Of Pediatric Early Warning Score In Identifying Critically Ill Children

Objective: It is a retrospective analysis of children's Early Warning Score(Pediatric Early Warning Score,PEWS)in children with identifying critical value.Methods:To retrospectively analyze the value of early warning score(Pediatric Early Warning Score,PEWS)in identifying critically ill children.Methods: The study retrospectively collected the information of children admitted by pediatric outpatient and emergency department of the first affiliated hospital of Xinjiang Medical University from June 2018 to June 2019.Taking the pediatric critical case score(PCIS)as the gold standard to judge the critical condition,378 children with PCIS score ?80 were selected as the critical condition group,and 378 children with age and sex matched PCIS score >80 as the control group.PEWS score was recorded and compared with gold standard.the optimal cut-off value was determined PEWS identified critically ill children by subject work characteristic curve(ROC curve),and sensitivity,specificity,Youden index were calculated.The sensitivity of PEWS score to identify critical diseases in different systems was studied.the relationship between PEWS score and intervention requirement was explored.Results: Among 756 children,the critical group and the control group were 378,the gender and age of the two groups were not statistically significant.The mortality rate of the critical group was significantly greater than that of the control group(P<0.01),and the PEWS score of the critical group was significantly greater than that of the control group(P<0.01).PEWS scores of each system disease in the critical group were compared,and there was no significant difference in the PEWS scores among the system diseases(P>0.01).The best cut-off value for identifying critically ill children with PEWS score was 3.5.the area under the ROC curve for identifying critically ill children was 0.967(95% CI :0.957~0.978),the sensitivity was 81.75%,and the specificity was 98.68%.an area of 0.812(95%CI : 0.727~0.898)under the curve for PEWS score identification of respiratory disease critical,sensitivity 82.35%,specificity 65.22%.the area under the curve for predicting circulatory critical illness was0.809(95%CI:0.743~-0.875)with a sensitivity of 79.31% and a specificity of 65.89%.The number of rescue times was related to the PEWS score.The higher the PEWS score,the more rescue times,the PEWS score was significantly higher than that of the children without rescue(7.0 VS.3.0,P<0.001).The PEWS score of children rescued once was significantly higher than that of children rescued many times(6.0 VS.7.0,P=0.002).To compare the mortality of the three groups according to the PEWS score,?3 group died 0,4-6 group died 1,the mortality rate was 0.47%,?7 group died 14,the mortality rate was 14.58%,the results showed that the mortality difference of the three groups was statistically significant(P < 0.01).Conclusion: The early warning score of children has important value in identifying critically ill children,and can identify the deterioration of children's condition.When the PEWS score ?3.5,it is recommended to transfer to PICU for further treatment so as not to delay the disease.The sensitivity of PEWS score to identify critical diseases of different systems is different,PEWS score to identify critical diseases of respiratory system is the highest accuracy,and the ability to identify critical diseases of circulatory system is the second.Children with higher PEWS scores have increased demand for rescue measures.PEWS score has certain predictive value for the prognosis of children.