Çocuk Acil Gözlem Odasında izlenen hastalarda Pediatrik Erken Uyarı Skorunun ve Pediatrik Yatış Riski Skorlaması II’nin etkisinin değerlendirilmesi

Abstract

One of the most important features of a pediatric emergency department is that the decision can be made for inpatient or outpatient treatment. For this reason, in hospitals where the severity of diseases are evaluated in emergency departments, hospitalizations are generally used. However, it can sometimes be very difficult to identify critical patients or to identify patients who will require hospitalization in a short time. Therefore, in order to see the deterioration potential of the patients in advance and to intervene in time, scoring including objective and physiological parameters is needed. Pediatric Early Warning Score (PEWS) and The Pediatric Risk of Hospital Admission Score II (PRISA II) have been developed for this purpose. In this study; In triage, the efficacy of the PEUS score viewed during admission to the observation room, at the 6th hour of the follow-up, and during hospitalization from the observation room, and the PRISA II scores examined during admission to the observation room were evaluated. Patients who applied to the pediatric emergency department of our hospital between July 1, 2019 and December 31, 2019 for any reason and who were taken to the pediatric emergency observation room were included in the study. While 40.7% of the patients were hospitalized, 6.6% were followed up in the pediatric intensive care unit. It was seen that each point increase in the PEWS score evaluated in triage increased the hospitalization risk by 1.37 times and the intensive care hospitalization risk by 1.48 times. It was observed that high PEWS and PRISA II scores were associated with hospital and intensive care hospitalization, PEWS ≥ 2 and ≥ 3, PRISA II score ≥11 and ≥16 as the cut-off points. However, it was seen that PEWS score '3' could predict hospitalization and PEWS score '4' could predict intensive care hospitalization with higher specificity and accuracy. Consequently, high PEWS and PRISA II scores should be taken seriously when making the admission decision of the patients who were taken to the emergency observation room, but the low scores were insufficient to exclude the hospitalization; If the PEWS score at the 6th hour of the observation was 4 or more, it was seen that the patient should not be discharged or hospitalized, and the PEUS score was more likely to show hospitalization in medical diseases. More studies are needed with different criteria and existing scores to be used in determining the hospitalization of the patients from the emergency departments.