急诊儿科改良早期预警评分的设计与验证

Design and validation of a modified early warning score for emergency pediatrics department

目的设计急诊儿科病情评估的评分系统,探讨其对危重症患儿的识别作用。方法参考儿童早期预警评分(PEWS)的相关文献、儿童生命支持指南,设计一种评分系统,称急诊儿科改良早期预警评分,使用该评分系统对入住我院儿童重症监护病房(PICU)的病例进行评估,分析不同病情患儿的评分值。结果急诊儿科改良早期预警评分识别危重症患儿受试者工作特征(ROC)曲线的曲线下面积(AUC)为0.95,最佳截断值为6,95%置信区间(CI)为5.5~6.5,灵敏度为84.70%,特异度为91.90%。结论急诊儿科改良早期预警评分可作为早期识别危重症患儿的评分工具,协助医护人员判断患儿病情,但尚需前瞻性、多中心研究进一步验证。

Objective To design a scoring system of assessment of the condition for emergency pediatrics department and to explore its role in identifying critically ill children.Methods A scoring system,called the modified early warning score for emergency pediatrics department,was designed with reference to the literature related to the pediatric early warning score(PEWS)and the life support guidelines for children,using which to score cases admitted in pediatric intensive care unit(PICU)of our hospital and analyze the scoring values of children with different conditions.Results The area under curve(AUC)of the receiver operating characteristic(ROC)curve of modified early warning score for emergency pediatrics department in identifying critically ill children was 0.95,the best cut-off value was 6,the 95%confidence interval(CI)was 5.5-6.5,the sensitivity was 84.70%,and the specificity was 91.90%.Conclusion The modified early warning score for emergency pediatrics department could be used as a scoring tool for early identification of critically ill children and assisted health care workers to judge the condition of the children,but it needs further validation in prospective,multicenter studies.