土耳其版儿科预警评分的有效性和可靠性研究

Sevda AKDENİZ, Hatice SELÇUK KUŞDERCİ, Şenay CANİKLİ ADIGÜZEL, Pınar OZBUDAK, Serkan DOGRU, Ekrem AKDENİZ, Gökçen BAŞARANOĞLU, Mustafa SÜREN
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 Material and Methods: This study was conducted between May and October 2022 on 228 patients aged 17 and under in the pediatric emergency department of a tertiary care hospital. In the pilot phase of the study, scoring of the first 30 patients was performed by three nurses in the emergency department. In the second phase, the validity of the PEWS scale was evaluated. Validity of the scoring system in predicting admission was assessed using area under the receiver operating characteristics (ROC) curve (AUC), sensitivity, and specificity, positive predictive value (PPV) and negative predictive value (NPV).
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摘要

目的:儿科早期预警评分(PEWS)可以识别有临床恶化风险的儿科患者,并可以帮助经验丰富的无助的提供者了解哪些患者可能需要升级护理。本研究的目的是将PEWS纳入土耳其,并评估其在急诊儿科患者中的有效性。& # x0D;材料和方法:本研究于2022年5月至10月在一家三级医院的儿科急诊科对228名17岁及以下的患者进行了研究。在研究的试点阶段,前30名患者的评分由急诊科的三名护士进行。第二阶段,评估PEWS量表的效度。采用受试者工作特征(ROC)曲线下面积(AUC)、敏感性和特异性、阳性预测值(PPV)和阴性预测值(NPV)评估评分系统预测入院的有效性。结果:患儿平均年龄为6.37±4.72岁。第一阶段表现出良好的评估间信度(kappa = 0.75)。在II期研究中,22名患者(9.6%)在研究期间入住重症监护病房(ICU)。预测AUC为0.948 (95% CI: 0.915-0.981)。根据ROC曲线分析,入住ICU的PEWS评分临界值为4 (PEWS >4)。截止值PEWS≥4预测ICU入院的敏感性和特异性分别为86.36%和90.78% (PPV, 50%;NPV, 90.48%)。以PEWS≥1为临界值预测入院的敏感性和特异性分别为100%和59.22% (PPV, 20.75%;NPV, 100%)强生# x0D;结论:土耳其版的PEWS有助于评估儿科急诊科患者的状态,有效性可接受,可作为预测ICU入院的潜在筛查工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pediatrik erken uyarı skorunun Türkçe versiyonunun geçerlilik ve güvenirlik çalışması
Aim: The pediatric early warning score (PEWS) identifies pediatric patients at risk for clinical deterioration and can helpless-experienced providers get a sense of which patients may need escalation of care. The purpose of the study was to adapt the PEWS into Turkish and evaluate its validity in pediatric patients admitted to the emergency. Material and Methods: This study was conducted between May and October 2022 on 228 patients aged 17 and under in the pediatric emergency department of a tertiary care hospital. In the pilot phase of the study, scoring of the first 30 patients was performed by three nurses in the emergency department. In the second phase, the validity of the PEWS scale was evaluated. Validity of the scoring system in predicting admission was assessed using area under the receiver operating characteristics (ROC) curve (AUC), sensitivity, and specificity, positive predictive value (PPV) and negative predictive value (NPV). Results: The mean age of the children was 6.37 ± 4.72 years. Phase I demonstrated good inter-rater reliability (kappa = 0.75). In phase II, 22 patients (9.6%) were admitted to the intensive care unit (ICU) during the study period. AUC for predicting was 0.948 (95% CI: 0.915–0.981). According to ROC curve analysis, a cut-off value for PEWS score was found to be 4 (PEWS >4) for admitted to the ICU. Sensitivity and specificity in predicting ICU admission with the cut-off PEWS ≥4 was 86.36% and 90.78%, respectively (PPV, 50%; NPV, 90.48%). The sensitivity and specificity in predicting admission with a cut-off of PEWS ≥1 was 100% and 59.22%, respectively (PPV, 20.75%; NPV, 100%). Conclusion: The Turkish version of PEWS can be helpful in assessing patient status in pediatric emergency department with acceptable validity and can serve as a potentially screening tool for prediction of ICU admission.
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