在快速反应之前的儿科早期预警得分 预测不好 集中护理病房转移
Jimin Lee1,2, Jennifer L Ciuchta1,3, Jacqueline Weingarten-Arams1
1Department of Pediatrics, Children's Hospital at Montefiore, Bronx, New York.
Hospital pediatrics
|October 29, 2024
概括
儿科早期预警分数 (PEWS) 没有有效地预测儿科快速反应小组 (RRT) 激活后的非计划性 PICU 转移或快速升级. 这项研究表明,在资源丰富的环境中,PEWS可能不是确定有风险儿童的可靠工具.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 临床风险评估工具 临床风险评估工具
- 患者安全 患者安全
背景情况:
- 儿科早期预警分数 (PEWS) 用于识别有恶化风险的儿童.
- 它的有效性,特别是在资源丰富的环境中,是有争议的.
- 这项研究评估了PEWS用于预测RRT激活后的计划外PICU转移.
研究的目的:
- 评估儿科早期预警分数 (PEWS) 的预测性能.
- 为了确定PEWS是否可以预测儿科快速响应小组 (RRT) 激活后未计划的PICU转移.
- 评估PEWS能够预测护理的快速升级的能力.
主要方法:
- 儿科患者 (21岁以下) 具有RRT激活的回顾性队列研究.
- 收集了人口统计,临床数据,RRT原因和修改的布莱顿PEWS.
- 分析了PICU转移和护理的快速升级作为结果;计算了灵敏度,特异性和AUROC.
主要成果:
- 在297次RRT激活中,有183次 (63%) 导致PICU转移,主要是呼吸.
- 在89%的RRT激活中,PEWS被记录在4小时内.
- PEWS显示PICU转移或快速升级的预测值较低 (AUROC 0.495-0.613).
结论:
- 在RRT激活前4小时内PEWS预测的PICU转移或快速升级不好.
- 目前的PEWS可能缺乏此目的的敏感性和特异性.
- 开发改进的预测工具是必要的.
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