Comparison of Pediatric Early Warning Score to Physician Opinion for Deteriorating Patients

J. B. Fenix, Catherine W. Gillespie, Amanda Levin, Nathan Dean

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


BACKGROUND: This study compares a Pediatric Early Warning Score (PEWS) to physician opinion in identifying patients at risk for deterioration.

METHODS: Maximum PEWS recorded during each admission was retrospectively ascertained from electronic medical record data. Physician opinion regarding risk of subsequent deterioration was determined by assignment to an institutional "senior sign-out" (SSO) list that highlights patients whom senior pediatric residents have identified as at risk. Deterioration events were defined as intubation, initiation of high flow nasal cannula, inotropes, noninvasive mechanical ventilation, or aggressive fluid resuscitation within 12 hours of transfer to the PICU. We assessed the relationships of sociodemographic variables, PEWS, and SSO assignment with subsequent deterioration events using multivariate regression analysis to control for a number of covariates.

RESULTS: There were 97 patients with nonelective transfers to the PICU who were eligible for placement on the SSO lists before transfer, 51 of whom experienced qualifying deterioration events. Maximum recorded PEWS was significantly higher for patients with a subsequent deterioration event during the first 12 hours after transfer, compared with those who were transferred but did not experience a deterioration event in the first 12 hours (mean [SD]: 3.9 [2.0] vs 2.9 [2.0]; P = .01). This association persisted even after multivariate adjustment. SSO assignment was only marginally associated with risk of deterioration among this patient population, with or without adjustment for covariates.

CONCLUSIONS: The PEWS was significantly associated with ICU deterioration, whereas physician opinion was not. Used alone or in conjunction with physician assessment, PEWS is a valuable tool for identifying patients vulnerable to acute deterioration.

Original languageEnglish (US)
Pages (from-to)474-479
Number of pages6
JournalHospital Pediatrics
Issue number9
StatePublished - Sep 1 2015
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pediatrics


Dive into the research topics of 'Comparison of Pediatric Early Warning Score to Physician Opinion for Deteriorating Patients'. Together they form a unique fingerprint.

Cite this