Cardiac Children's Hospital Early Warning Score: Italian Validation
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Published on: April 29, 2013
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.
