Aplicación de la escala de alerta temprana (PEWS) como herramienta para predecir el riesgo de deterioro clínico en los pacientes ingresados al servicio de urgencias del Hospital Roberto Gilbert de enero a junio de 2022.

Abstract

Introduction: Early detection of potentially serious conditions and timely intervention are crucial to avoid serious harm in pediatric patients leading to significant sequelae, disability or death. Early warning scales are designed to recognize physiological changes that precede clinical deterioration in hospitalized patients. In the local population, no studies have been carried out on the usefulness of the PEWS scale to predict risk in patients admitted to emergency departments. Objectives: Determine the usefulness of applying the early warning scale (PEWS) to predict the risk of clinical deterioration in patients admitted to the emergency department of the Roberto Gilbert Hospital. Materials and methods: A prospective, observational, longitudinal, analytical study was carried out, which includes patients between 28 days and 17 years old who have been admitted to the emergency department for any diagnosis. Two measurements of the PEWS scale were made, the first upon admission and the second after 2 hours, during which time initial interventions were carried out in order to identify the values that had the best sensitivity and specificity to predict clinical deterioration. Results: A total of 730 patients who met inclusion criteria were included, of which 40% were male, 60% female, with 33% being infants the most affected group. ROC curves were made to determine best values that correspond to the admission PEWS, a value of 3 has sensitivity 93% and specificity 89%, at 2 hours the best value was 2 with sensitivity 92% and specificity 89%, values of sensitivity and specificity for each adverse event. Conclusions: The PEWS score is a useful clinical tool for the early detection of clinical deterioration. The corresponding cuts for each adverse event should cause the emergency care physician to execute maneuvers to stabilize the patient.