Objective: The objective of this study was to determine the association between the Pediatric Early Warning Score (PEWS) at time of emergency department (ED) disposition and level of care.
Methods: We conducted a prospective observational study with a convenience sample of patients aged 0 to 21 years in the ED of an urban, tertiary care children's hospital between November 2010 and July 2011. Pediatric Early Warning Score data were obtained at time of ED disposition, and the disposition decision was collected from the electronic medical record. Multinomial logistic regression was used to determine the association between PEWS and disposition.
Results: The sample of 383 patients included 239 (62%) who were discharged, 126 (33%) admitted to acute care, and 18 (5%) admitted to intensive care. Assigned scores ranged from 0 to 9. Adjusting for triage level, a 1-point increase in PEWS increased the odds of acute care admission 48% relative to the odds of discharge (odds ratio, 1.48; 95% confidence interval, 1.25-1.76) and increased the odds of intensive care admission 41% relative to the odds of acute care admission (odds ratio, 1.41; 95% confidence interval, 1.13-1.76). Pediatric Early Warning Score of 1 or more had maximum discriminant ability for admission, and PEWS of 3 or greater had maximum discriminant ability for intensive care. Area under the receiver operator characteristic curve was 0.68 to detect need for admission for the entire sample and 0.80 among the 97 patients with respiratory complaints.
Conclusions: Pediatric Early Warning Score is associated with the level of care at ED disposition but does not provide adequate sensitivity and specificity to be used in isolation. Performance characteristics are better for patients with respiratory complaints.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/PEC.0000000000000063 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Retrograde intramedullary headless compression screw fixation for pediatric mid-diaphyseal proximal phalanx malunion: A case study.
Int J Surg Case Rep
January 2025
Department of Orthopaedics and Traumatology, AZ Delta, Deltalaan 1, 8800 Roeselare, Belgium; Department of Cardio and Organ Systems, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium. Electronic address:
Introduction: Proximal phalanx fractures in children, especially mid-diaphyseal fractures, can result in malunion and significant functional impairment. Early malunions require prompt and effective intervention to prevent long-term complications. This case study highlights the use of intramedullary headless compression screw (IMHCS) fixation in addressing a proximal phalanx malunion.
View Article and Find Full Text PDFDevelopmental trajectories of visual orienting functions in children born very or extremely preterm.
Early Hum Dev
January 2025
Vestibular and Oculomotor Research Group, Department of Neuroscience, Erasmus MC, Rotterdam, the Netherlands. Electronic address:
Background And Aims: Preterm birth increases the risk of neurodevelopmental impairments, such as Cerebral Visual Impairment (CVI), which affects visual processing. Assessing visual functions in young children is challenging with traditional methods that often rely on verbal/motor responses. The aim of the study was to investigate the developmental trajectories of Visual Orienting Functions (VOF) in children born very preterm (<32 weeks gestational age) between 2 and 5 years corrected age (CA) using eye tracking.
View Article and Find Full Text PDFIn toto biological framework: Modeling interconnectedness during human development.
Dev Cell
January 2025
Premium Research Institute for Human Metaverse Medicine (WPI-PRIMe), Graduate School of Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Human Biology Research Unit, Institute of Integrated Research, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan; Divisions of Gastroenterology, Hepatology & Nutrition, and Developmental Biology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA; Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA; Center for Stem Cell and Organoid Medicine (CuSTOM), Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA. Electronic address:
Recent advancements in pluripotent stem cell and synthetic tissue technology have brought significant breakthroughs in studying early embryonic development, particularly within the first trimester of development in humans. However, during fetal stage development, investigating further biological events represents a major challenge, partly due to the evolving complexity and continued interaction across multiple organ systems. To bridge this gap, we propose an "in toto" biological framework that leverages a triad of technologies: synthetic tissues, intravital microscopy, and computer vision to capture in vivo cellular morphodynamics, conceptualized as single-cell choreography.
View Article and Find Full Text PDFComparison of Ultrasound Characteristics of Peripapillary Hyperreflective Ovoid Mass-Like Structures (PHOMS) and Optic Disc Drusen in Children.
J Neuroophthalmol
January 2025
Departments of Ophthalmology (DB, G-SY, GTL, RAA) and Neurology (DB, GTL, RAA), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; and Division of Ophthalmology (AG, GTL, RAA), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Background: In children, pseudopapilledema is frequently caused by peripapillary hyperreflective ovoid mass-like structures (PHOMS) or optic disc drusen (ODD). While enhanced depth imaging (EDI) OCT can identify both, lack of cooperation, especially from younger children due to the duration of testing, often necessitates the use of B-scan ultrasound (BSUS). This study investigated whether PHOMS are hyperreflective on BSUS and if BSUS can differentiate PHOMS from ODD.
View Article and Find Full Text PDFAim: To estimate the prevalence of early childhood caries and to study a possible influence on different ethnicities in preschool children aged 3 to 5 with social exclusion risk.
Background: Oral diseases are a major global public health problem, with negative effects at both individual and collective levels, and there is a relationship between socioeconomic characteristics such as income, occupation and educational level, with the prevalence and severity of oral diseases.
Methods: A cross sectional study was conducted in a sample of 288 preschool children belonging to three schools in the Southeastern Spain among other variables dmft and ICDASS index.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!