Your browser does not support JavaScript!

Home    Search  

Results - Details

Search command : Author="Μπριασούλης"  And Author="Γεώργιος"

Current Record: 8 of 96

Back to Results Previous page
Next page
Add to Basket
[Add to Basket]
Identifier 000454602
Title Η κλίμακα Pediatric Early Warning System (PEWS) ως εργαλείο αναγνώρισης και παρέμβασης της κλινικής επιδείνωσης στο Γενικό Νοσοκομείο Χανίων
Alternative Title Pediatric Early Warning System (PEWS) for detecting and responding to clinical deterioration in the General Hospital of Chania
Author Χριστολουκά, Μαρία
Thesis advisor Μπριασούλης, Γεώργιος
Reviewer Ηλία, Σταυρούλα
Παπαϊωάννου Ιωάννα
Abstract Background: Incidence of cardiopulmonary arrest in hospitalized children is extremely low (0,7-3%), but mortality and morbidity remain high despite the progress of resuscitation methods (11-37%). Research mainly conducted on the adult population has shown that during the period before the arrest or other serious incidences, the physiological parameters deteriorate. If these parameters were recognized earlier, the adverse events could have been prevented. It has been estimated that approximately one in five children who die in hospital has avoidable factors leading to death, and up to half of children have potentially avoidable factors. In response to these epidemiological data, the pediatric early warning score (PEWS) has been developed internationally to improve the safety of hospitalized children. Objective: The purpose of the study is to evaluate the use of the PEWS score for the early detection of children clinical deterioration and the appropriate modification of the patients' treatment at a Pediatric department in a regional General Hospital in Crete. Methods: This is a single-centre retrospective observational study including patients aged from 30 days to 16 years old who were hospitalized at the pediatric clinic of Chania hospital from July 2022 to December 2022. Patients' demographic data, imaging, laboratory findings, and outcome were all recorded. Their PEWS scores were recorded three times per day for two days. Results: During the period of observation the PEWS score was calculated in 201 hospitalized patients. Out of them, 190 were discharged home and 11 transported to an advanced Centre (tertiary hospital) or to ICU. Most of the patients that needed to be transferred were diagnosed with infection (81,8%), whilst among discharged patients’ infection was also the dominant infection (77,4%) followed by accidents (7,4%). Comorbidity ranged at low levels and was significantly higher in the transferred group (18,2%). The initial treatment was characterized by fluid replacement and antibiotics at a high rate, especially in the transferred group (90,9%) (p=0,010). The length of hospitalization was longer in the transferred group (3.7 vs. 3.3, p=0,018). The highest PEWS scores were noticed at the time of admission (PEWS 0). Their distribution in the following calculations followed a deceleration rate (mean scores 3- 1,5-0,3) among discharged patients while it remained at the level of 2 from 8th to 48th hour among transferred patients. In a ROC analysis, strong-predictive value ability of patients’ deterioration was shown in all calculated PEWS scores, with higher AUROC values at 40h. Among different time -series, only the 48th-hour PEWS (AUROC 0,79 (95%CI 0,60-0,98), p=0,006) and marginally the 24th-hour (AUROC 0,70 (95%CI 0,51-0,90), p=0,055) were able to predict the need to transfer the patient to a tertiary Centre. Conclusion: Despite the small number of participating patients, results of this study show that the PEWS score detects clinical deterioration and the need for transfer to a tertiary Centre.
Language Greek
Issue date 2023-04-05
Collection   School/Department--School of Medicine--Department of Medicine--Post-graduate theses
  Type of Work--Post-graduate theses
Permanent Link https://elocus.lib.uoc.gr//dlib/b/6/a/metadata-dlib-1681978986-668666-9861.tkl Bookmark and Share
Views 405

Digital Documents
No preview available

Download document
View document
Views : 4