Development and initial validation of the Bedside Paediatric Early Warning System score.

Area of Science:

• Pediatric critical care medicine
• Clinical risk stratification
• Patient safety in hospitals

Background:

• Adverse outcomes in hospitalized children are often preventable.
• Identifying children needing critical care referral is challenging.
• A simple bedside score is needed to assess illness severity.

Purpose of the Study:

• To develop and validate a simple bedside score for quantifying illness severity in hospitalized children.
• To improve the identification of children requiring critical care expertise.

Main Methods:

• A case-control design evaluated 11 candidate items.
• The study involved case-patients urgently admitted to the ICU and control-patients.
• Validation used two prospectively collected datasets.

Main Results:

• The 7-item Bedside Paediatric Early Warning System (PEWS) score (0-26) was developed.
• The area under the ROC curve was 0.91, outperforming nurse ratings (0.84).
• At a score of 8, sensitivity was 82% and specificity was 93%; the score increased before ICU admission.

Conclusions:

• The Bedside PEWS score was developed and initially validated.
• This score quantifies illness severity and identifies critically ill children with advance notice.
• Further prospective validation is needed before widespread clinical use.