Singleton Hospital

Objective: To develop and test the predictability of a paediatric early warning score to identify children at risk of developing critical illness. Design: Prospective cohort study. Setting: Admissions to all paediatric wards at the University Hospital of Wales. Outcome measures: Respiratory arrest, cardiac arrest, paediatric high dependency unit admission, paediatric intensive care unit admission, and death. Results: Data were collected on 1000 patients. A single abnormal observation determined by the Cardiff and Vale Paediatric Early Warning System (C&VPEWS) had a 89.0 % sensitivity (95 % CI, 80.5- 94.1), 63.9 % specificity (95 % CI, 63.8-63.9), 2.2 % positive predictive value (95 % CI, 2.0 – 2.3) and a 99.8 % negative predictive value (95 % CI, 99.7- 99.9) for identifying children who subsequently had an adverse outcome. The area under the receiver operating characteristic curve for the C&VPEWS score was 0.86 (95 % CI, 0.82 – 0.91). Conclusion: Identifying children likely to develop critical illness can be difficult