Article Text

other Versions

PDF
Prospective cohort study to test the predictability of the Cardiff and Vale Paediatric Early Warning System (C&VPEWS)
  1. Elizabeth Dawn Edwards (dawn{at}llandybie89.freeserve.co.uk)
  1. Swansea NHS Trust, United Kingdom
    1. Colin V Powell (colin.powell{at}cardiffandvale.wales.nhs.uk)
    1. Cardiff and Vale NHS Trust, United Kingdom
      1. Brendan W Mason (brendan.mason{at}nphs.wales.nhs.uk)
      1. Cardiff University, United Kingdom
        1. Alison Oliver (alison.oliver{at}cardiffandvale.wales.nhs.uk)
        1. Cardiff and Vale NHS Trust, United Kingdom

          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.

          Statistics from Altmetric.com

          Request permissions

          If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

          Linked Articles

          • Atoms
            Howard Bauchner