Evaluating the paediatric early warning system score in patients admitted in the department of paediatrics in a tertiary care hospital in North India

Background: There is a requirement for a screening tool that can be used for a quick and easy clinical assessment of a patient presenting in the emergency department (ED).  
Objectives: To evaluate the paediatric early warning system (PEWS) score in patients admitted in the department of paediatrics in a tertiary care hospital in North India.
Method: This was a prospective observational study on 50 patients aged 1 month–14 years reporting to the paediatric ED of a tertiary care hospital. They were evaluated using the modified version of Brighton PEWS score at the time of admission by the paediatric resident, and the scores were correlated with their final outcome and their requirement to be shifted to the paediatric intensive care unit (PICU) within 6 hours and 24 hours. A receiver operating characteristics (ROC) curve was plotted to determine the cut-off value for PEWS score and the sensitivity and the specificity of the value.
Results:  ROC of the initial PEWS score by the paediatric resident in the ED showed an area under the curve (AUC) of 0.778 (95% CI: 0.738–0.808) with standard error of 0.024. AUC of derived cut-off of PEWS was 3, with sensitivity 68.8% (95% CI: 62.48–75.36%), specificity 78.8% (95% CI: 73.48–81.22%), positive likelihood ratio 3.04 (95% CI: 2.26–3.446), and negative likelihood ratio 0.42 (95% CI: 0.36–0.54).
Conclusions: PEWS score can be used for the objective assessment to predict admission to PICU or ward or even early shifting of patient from ward to PICU.