Related Experiment Video
Updated: Sep 15, 2025
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
NEED FOR INTENSIVE CARE UNIT ADMISSION, MORTALITY RATE AND ASSOCIATED FACTORS USING PAEDIATRIC ADVANCED WARNING SCORE
Matei Mselle1,2, Bladina Mmbaga1,2, Aisa Shayo1,2
1Kilimanjaro Christian Medical College (KCMUCo), Tanzania.
Insights
The Pediatric Advanced Warning Score (PAWS) effectively identifies children needing intensive care unit (ICU) admission and predicts higher mortality risk. Implementing PAWS in emergency departments can improve patient outcomes in critical care settings.
Area of Science:
- Pediatric Critical Care Medicine
- Emergency Medicine
- Health Services Research
Background:
- Pediatric intensive care units (PICUs) manage critically ill children.
- Pediatric early warning scores can predict deterioration hours in advance.
- Delayed ICU admission is linked to increased mortality.
Purpose of the Study:
- To assess the Pediatric Advanced Warning Score (PAWS) for predicting ICU admission and mortality in pediatric patients.
- To identify factors associated with ICU admission and mortality using PAWS.
Main Methods:
- Prospective observational cohort study of pediatric patients (1 month-14 years) in the emergency department.
- PAWS assessed on arrival, categorized as critical (≥4) or non-critical (<4).
- Patients followed until discharge; outcomes compared with initial PAWS.
Main Results:
- 80% of ICU admissions had a critical PAWS score (p<0.001).
- Overall ICU mortality was 52.7%, with 86.2% of deaths occurring in patients with a critical PAWS score (p<0.001).
- Critical PAWS scores were associated with increased ICU length of stay.
Conclusions:
- PAWS on emergency arrival accurately identifies children requiring ICU admission (up to 80%).
- PAWS can be integrated into ICU admission criteria, especially in low- and middle-income countries.
- Critical PAWS scores indicate a higher risk of death and prolonged ICU stay.
Background:
Pediatric intensive care units (PICUs) are special areas of service to save the lives of children with life-threatening conditions/or critically ill children. Pediatric early warning scores can accurately identify up to 85% of children who will experience deterioration as early as 11 hours before, with specificity up to 95%. Delayed ICU admission has been reported to be associated with increase in mortality.
Objective:
To determine the need for ICU admission, mortality rate and associated factors using pediatric advanced warning score (PAWS) on arrival at Hospital.
Methodology:
This was a prospective observational cohort study, conducted among pediatric patients aged 1month-14yrs arriving through Emergency department at Kilimanjaro Christian medical center. Initial PAW score was done by trained senior resident then grouped into two groups critical score of ≥4, and none critical <4. Each patient was followed up until discharge where the outcome was recorded and matched with the PAW scored.Data were analyzed through SPSS version 25; logistic and poison regression model were used to measure the association and comparison between groups was done by non-parametric 2 independent sample.
Results:
310 were enrolled during study period,35.4%(n=110) were admitted in ICU. The median age was 29 and 21 months for all participants and for those admitted to ICU, respectively. 80% of ICU admission had critical PAW score on arrival, with significant association (p<0.001).There was statistically significant difference between critical score and non-criticalin need for admission Mann-Whitney test (p<0.001). Overall ICU mortality rate was 52.7%(n=58). Those who died, 86.2%(n=50) had critical score on admission, and there was statistically significance difference between critical score and non-critical in terms of mortality, Mann-Whitney test (p<0.001). Otherwise, those with critical PAW score were likely to stay longer in ICU.
Conclusion:
PAW score right on arrival at emergency can identify up to 80% of pediatric patient requiring ICU admission, thus maybe incorporated in ICU admission criteria in low and middle income countries. Critical PAW score on arrival have increased chance of death and staying longer in ICU.
More Related Videos
05:16Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
10:38Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
Related Concept Videos
01:23Acute Respiratory Failure-IV
01:30Pneumonia III: Complications and Assessment
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:29Pulmonary Embolism I: Introduction
01:20Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
01:19Factors Affecting Pulmonary Ventilation
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...