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Early Warning System for PICU Transfer Evaluated
Cancer; ePub 2017 Sep 7; Agulnik, Aceituno, et al
Pediatric early warning systems (PEWS) accurately predicted the need for unplanned pediatric ICU transfer in children with cancer, according to a retrospective case-control study involving 258 individuals. Participants were treated at resource-limited hospitals. Investigators compared the highest documented and corrected PEWS score before unplanned ICU transfer in children with cancer (n=129) to matched controls who did not require transfer (n=129). Among the results:
- Documented and corrected PEWS scores were highly correlated with the need for ICU transfer.
- PEWS scores rose 24 hours prior to unplanned transfer.
- Among patients transferred, organ dysfunction at the time of ICU admission correlated with maximum PEWS score.
- PEWS results were higher in those with septic shock.
- ICU mortality rate was 17%.
- Those who did not survive had higher average PEWS scores before transfer.
- A 1-point increase in PEWS score increased the odds of requiring mechanical ventilation by 30% and the odds of needing vasopressors by 40%.
Agulnik A, Aceituno A, Robles L, et al. Validation of a pediatric early warning system for hospitalized pediatric oncology patients in a resource-limited setting. [Published online ahead of print September 7, 2017]. Cancer. doi:10.1002/cncr.30951.