The Association Between Fever and Subsequent Deterioration Among Hospitalized Children With Elevated PEWS.
Journal
Hospital pediatrics
ISSN: 2154-1663
Titre abrégé: Hosp Pediatr
Pays: United States
ID NLM: 101585349
Informations de publication
Date de publication:
03 2019
03 2019
Historique:
pubmed:
15
2
2019
medline:
1
4
2020
entrez:
15
2
2019
Statut:
ppublish
Résumé
To evaluate the association between fever and subsequent deterioration among patients with Pediatric Early Warning Score (PEWS) elevations to ≥4 to inform improvements to care escalation processes at our institution. We performed a cohort study of hospitalized children at a single quaternary children's hospital with PEWS elevations to ≥4 between January 1, 2014 and March 31, 2014. Bivariable analysis was used to compare characteristics between patients with and without unplanned ICU transfers and critical deterioration events (CDEs) (ie, unplanned ICU transfers with life-sustaining interventions initiated in the first 12 ICU hours). A multivariable Poisson regression was used to assess the relative risk of unplanned ICU transfers and CDEs. The study population included 220 PEWS elevations from 176 unique patients. Of those, 33% had fever ( At our institution, patients with an elevated PEWS appeared less likely to experience an unplanned ICU transfer if they were febrile. We were underpowered to evaluate the effect on CDEs. These findings contributed to our recognition that (1) PEWS may not include all relevant clinical factors used for clinical decision-making regarding care escalation and (2) further study is needed in this area.
Identifiants
pubmed: 30760491
pii: hpeds.2018-0187
doi: 10.1542/hpeds.2018-0187
pmc: PMC6391037
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
170-178Informations de copyright
Copyright © 2019 by the American Academy of Pediatrics.
Déclaration de conflit d'intérêts
POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.
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