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Cardiac Children's Hospital Early Warning Score: Italian Validation
Silvio Simeone1, Nicol Platone2, Nicola Serra3
1Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
Insights
The Italian Cardiac Children's Hospital Early Warning Score (C-CHEWS) accurately identifies deteriorating pediatric cardiac patients, aiding timely ICU transfers. This validated tool supports healthcare professionals in early detection and treatment.
Area of Science:
- Pediatric Cardiology
- Clinical Assessment Tools
- Patient Monitoring
Background:
- The Cardiac Children's Hospital Early Warning Score (C-CHEWS) is crucial for identifying clinical deterioration in pediatric patients.
- No prior studies have validated the C-CHEWS in an Italian pediatric cardiac population.
Purpose of the Study:
- To translate and back-translate the C-CHEWS into Italian.
- To validate the Italian version of the C-CHEWS and its algorithm for use in Italian pediatric cardiac patients.
Main Methods:
- A retrospective study design was employed.
- Performance was evaluated using sensitivity, specificity, accuracy, positive predictive value, and negative predictive value.
- Cohen's kappa statistic assessed agreement between C-CHEWS score (≥5) and actual ICU transfer.
Main Results:
- The Italian C-CHEWS demonstrated high performance: sensitivity (81.5%), specificity (99.6%), accuracy (99.7%), PPV (86.7%), NPV (99.8%).
- Cohen's kappa was 0.837 (p<0.001), indicating excellent agreement between a C-CHEWS score ≥5 and ICU transfer decisions.
Conclusions:
- The Italian C-CHEWS is a sensitive, specific, and reliable tool for early detection of deterioration in hospitalized pediatric cardiac surgical patients.
- This validated tool can assist healthcare professionals in prompt recognition, treatment, and facilitation of PICU transfers.
Background/Purpose:
The Cardiac Children's Hospital Early Warning Score (C-CHEWS) is an early warning scale used to identify paediatric patients experiencing clinical deterioration which may warrant a transfer to an ICU. However, no studies have tested the C-CHEWS in an Italian paediatric cardiac population. The aims of this study were to translate/back-translate and validate the Italian version of the C-CHEWS and its algorithm.
Design And Method:
Retrospective study. Sensitivity, specificity, accuracy, positive predictive value, negative predictive value were used to evaluate the performance of C-CHEWS. In additions the Cohen's kappa statistic was calculated to evaluate the agreement between patient's status described by C-CHEWS score (≥5) and actual ICU transfer.
Results:
High discrimination was observed for sensitivity (81.5%), specificity (99.6%), accuracy (99.7%), positive predictive value (86.7%), and negative predictive value (99.8%). The Cohen's kappa score was observed to be equal to 0.837 (p-value <0.001) indicating there was excellent significant agreement between a C-CHEWS score ≥ 5 and effective evaluation for patients transfer to an ICU.
Conclusion:
The Italian version of the C-CHEWS proved to be a sensitive, specific and reliable tool in the early detection of a physical deterioration of hospitalized paediatric cardiac surgical patients.
Practice Implications:
This tool may help doctors, nurses and all healthcare professionals to promptly recognize and treat clinical deterioration and facilitate urgent transfers to the PICU.
