Comparison between Paediatric Advanced Warning Score (PAWS) and Paediatric Early Warning Score (PEWS) in Predicting Intensive Care Unit Admissions in Children

Background: Children with varying severity of illness seek medical care and early identification of patients at risk of clinical deterioration along with appropriate level of care are integral components of high-quality medical care. The paediatric advanced warning score (PAWS) is a newer scoring sy...

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Main Authors: Hitha Rose Mathew, Sweta Shanbhag, Habeeb Ullah Khan
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-04-01
Series:Journal of Medical Evidence
Subjects:
Online Access:https://journals.lww.com/10.4103/JME.JME_139_24
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author Hitha Rose Mathew
Sweta Shanbhag
Habeeb Ullah Khan
author_facet Hitha Rose Mathew
Sweta Shanbhag
Habeeb Ullah Khan
author_sort Hitha Rose Mathew
collection DOAJ
description Background: Children with varying severity of illness seek medical care and early identification of patients at risk of clinical deterioration along with appropriate level of care are integral components of high-quality medical care. The paediatric advanced warning score (PAWS) is a newer scoring system which takes additional parameters such as temperature, oxygen saturation and alert, verbal, pain, unresponsive (AVPU) scale compared to the widely used paediatric early warning score (PEWS). Aims: The aim of this study was to compare the utility of PAWS with PEWS for predicting intensive care unit (ICU) admissions in children. Materials and Methods: We conducted a prospective observational study, which included 1000 children aged 1 month to 15 years who presented to the emergency department. Focussed clinical assessment was done and PAWS and PEWS were assigned. Cutoff scores for predicting paediatric ICU admission for each of these scores were derived using the receiver operating characteristics (ROC) curve, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results: Out of 1000 children included in the study, 169 (16.9%) patients required admission – 107 to ward and 62 to ICU. For PAWS, the area under curve (AUC) for predicting ICU admission for a cutoff score of ≥3 was 0.969 (P < 0.0001) with sensitivity, specificity, PPV and NPV of 88%, 99%, 96.5% and 99.2%, respectively. For PEWS, AUC for predicting ICU admission for a cutoff score of ≥3 was 0.946 (P < 0.0001) with sensitivity, specificity, PPV and NPV of 41.9%, 99.6%, 89.6% and 99.2%, respectively. Conclusion: PAWS can serve as a better screening tool for prediction of ICU admission in children, as compared to PEWS.
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spelling doaj-art-e6073fca667947f7853a9484f39fe0792025-08-20T03:31:41ZengWolters Kluwer Medknow PublicationsJournal of Medical Evidence2667-07202667-07392025-04-016212713010.4103/JME.JME_139_24Comparison between Paediatric Advanced Warning Score (PAWS) and Paediatric Early Warning Score (PEWS) in Predicting Intensive Care Unit Admissions in ChildrenHitha Rose MathewSweta ShanbhagHabeeb Ullah KhanBackground: Children with varying severity of illness seek medical care and early identification of patients at risk of clinical deterioration along with appropriate level of care are integral components of high-quality medical care. The paediatric advanced warning score (PAWS) is a newer scoring system which takes additional parameters such as temperature, oxygen saturation and alert, verbal, pain, unresponsive (AVPU) scale compared to the widely used paediatric early warning score (PEWS). Aims: The aim of this study was to compare the utility of PAWS with PEWS for predicting intensive care unit (ICU) admissions in children. Materials and Methods: We conducted a prospective observational study, which included 1000 children aged 1 month to 15 years who presented to the emergency department. Focussed clinical assessment was done and PAWS and PEWS were assigned. Cutoff scores for predicting paediatric ICU admission for each of these scores were derived using the receiver operating characteristics (ROC) curve, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results: Out of 1000 children included in the study, 169 (16.9%) patients required admission – 107 to ward and 62 to ICU. For PAWS, the area under curve (AUC) for predicting ICU admission for a cutoff score of ≥3 was 0.969 (P < 0.0001) with sensitivity, specificity, PPV and NPV of 88%, 99%, 96.5% and 99.2%, respectively. For PEWS, AUC for predicting ICU admission for a cutoff score of ≥3 was 0.946 (P < 0.0001) with sensitivity, specificity, PPV and NPV of 41.9%, 99.6%, 89.6% and 99.2%, respectively. Conclusion: PAWS can serve as a better screening tool for prediction of ICU admission in children, as compared to PEWS.https://journals.lww.com/10.4103/JME.JME_139_24intensive care unit admissionspaediatric advanced warning score (paws)paediatric early warning score (pews)
spellingShingle Hitha Rose Mathew
Sweta Shanbhag
Habeeb Ullah Khan
Comparison between Paediatric Advanced Warning Score (PAWS) and Paediatric Early Warning Score (PEWS) in Predicting Intensive Care Unit Admissions in Children
Journal of Medical Evidence
intensive care unit admissions
paediatric advanced warning score (paws)
paediatric early warning score (pews)
title Comparison between Paediatric Advanced Warning Score (PAWS) and Paediatric Early Warning Score (PEWS) in Predicting Intensive Care Unit Admissions in Children
title_full Comparison between Paediatric Advanced Warning Score (PAWS) and Paediatric Early Warning Score (PEWS) in Predicting Intensive Care Unit Admissions in Children
title_fullStr Comparison between Paediatric Advanced Warning Score (PAWS) and Paediatric Early Warning Score (PEWS) in Predicting Intensive Care Unit Admissions in Children
title_full_unstemmed Comparison between Paediatric Advanced Warning Score (PAWS) and Paediatric Early Warning Score (PEWS) in Predicting Intensive Care Unit Admissions in Children
title_short Comparison between Paediatric Advanced Warning Score (PAWS) and Paediatric Early Warning Score (PEWS) in Predicting Intensive Care Unit Admissions in Children
title_sort comparison between paediatric advanced warning score paws and paediatric early warning score pews in predicting intensive care unit admissions in children
topic intensive care unit admissions
paediatric advanced warning score (paws)
paediatric early warning score (pews)
url https://journals.lww.com/10.4103/JME.JME_139_24
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AT habeebullahkhan comparisonbetweenpaediatricadvancedwarningscorepawsandpaediatricearlywarningscorepewsinpredictingintensivecareunitadmissionsinchildren