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Validation of the Emergency Department-Paediatric Early Warning Score (ED-PEWS) for use in low- and middle-income countries: A multicentre observational study.
Kemps, Naomi; Holband, Natanael; Boeddha, Navin P; Faal, Abdoulie; Juliana, Amadu E; Kavishe, Godfrey A; Keitel, Kristina; van 't Kruys, Kevin H; Ledger, Elizabeth V; Moll, Henriëtte A; Prentice, Andrew M; Secka, Fatou; Tan, Rainer; Usuf, Effua; Unger, Stefan A; Zachariasse, Joany M.
Afiliación
  • Kemps N; Department of General Paediatrics, Erasmus MC- Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
  • Holband N; Department of Paediatrics, Academic Hospital Paramaribo, Paramaribo, Suriname.
  • Boeddha NP; Department of General Paediatrics, Erasmus MC- Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
  • Faal A; Department of Paediatrics, Academic Hospital Paramaribo, Paramaribo, Suriname.
  • Juliana AE; Applications Development & e-Health Department, Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia.
  • Kavishe GA; Department of Paediatrics, Academic Hospital Paramaribo, Paramaribo, Suriname.
  • Keitel K; National Institute of Medical Research-Mbeya Medical Research Centre, Mbeya, Tanzania.
  • van 't Kruys KH; Division of Paediatric Emergency Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, Bern, Switzerland.
  • Ledger EV; Swiss Tropical and Public Health Institute (SwissTPH), University of Basel, Basel, Switzerland.
  • Moll HA; Department of Paediatrics, Academic Hospital Paramaribo, Paramaribo, Suriname.
  • Prentice AM; Department of Paediatrics, Bristol Royal Hospital for Children, Bristol, The United Kingdom.
  • Secka F; Department of General Paediatrics, Erasmus MC- Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
  • Tan R; Nutrition and Planetary Health Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia.
  • Usuf E; Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia.
  • Unger SA; Swiss Tropical and Public Health Institute (SwissTPH), University of Basel, Basel, Switzerland.
  • Zachariasse JM; Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
PLOS Glob Public Health ; 4(3): e0002716, 2024.
Article en En | MEDLINE | ID: mdl-38512949
ABSTRACT
Early recognition of children at risk of serious illness is essential in preventing morbidity and mortality, particularly in low- and middle-income countries (LMICs). This study aimed to validate the Emergency Department-Paediatric Early Warning Score (ED-PEWS) for use in acute care settings in LMICs. This observational study is based on previously collected clinical data from consecutive children attending four diverse settings in LMICs. Inclusion criteria and study periods (2010-2021) varied. We simulated the ED-PEWS, consisting of patient age, consciousness, work of breathing, respiratory rate, oxygen saturation, heart rate, and capillary refill time, based on the first available parameters. Discrimination was assessed by the area under the curve (AUC), sensitivity and specificity (previously defined cut-offs < 6 and ≥ 15). The outcome measure was for each setting a composite marker of high urgency. 41,917 visits from Gambia rural, 501 visits from Gambia urban, 2,608 visits from Suriname, and 1,682 visits from Tanzania were included. The proportion of high urgency was variable (range 4.6% to 24.9%). Performance ranged from AUC 0.80 (95%CI 0.70-0.89) in Gambia urban to 0.62 (95%CI 0.55-0.67) in Tanzania. The low-urgency cut-off showed a high sensitivity in all settings ranging from 0.83 (95%CI 0.81-0.84) to 1.00 (95%CI 0.97-1.00). The high-urgency cut-off showed a specificity ranging from 0.71 (95%CI 0.66-0.75) to 0.97 (95%CI 0.97-0.97). The ED-PEWS has a moderate to good performance for the recognition of high urgency children in these LMIC settings. The performance appears to have potential in improving the identification of high urgency children in LMICs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: PLOS Glob Public Health Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: PLOS Glob Public Health Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos