Use of an early warning scoring system in the pediatric ward of a tertiary referral hospital

OBJECTIVE: To evaluate the performance the Brighton Pediatric Early Warning Score for an early identification of clinical deterioration in children admitted to the pediatric ward of a tertiary hospital. METHODS: A prospective cohort observational study, involving 325 children with acute illnesses admitted to a pediatric ward, aged 29 days to 13 years, between August 2018 and March 2020. To assess the Brighton Pediatric Early Warning Score diagnostic accuracy, it was used the Cardiff and Vale Pediatric Early Warning System as reference, and the software used was the R Core Team 2020. The effectiveness of the Brighton Pediatric Early Warning Score was assessed using the indicators of sensitivity, specificity, positive predictive value, negative predictive value, area under the ROC curve, number of true positives and negatives and false positives and negatives. RESULTS: The Brighton Pediatric Early Warning Score showed a sensitivity of 19.2%, a specificity of 99.1%, a positive predictive value of 90.5%, a negative predictive value of 73.7%, and an area under the ROC curve of 0.839. In addition to that, for scores larger than 3, there were 19 true positives, 224 true negatives, 2 false positives and 80 false negatives. CONCLUSION: The Brighton Pediatric Early Warning Score performed well in the scenario analysis chosen by this research, showing how easy it is to use it for an early recognition of clinical deterioration in children admitted to pediatric wards.