PEDIATRIC EARLY WARNING SCORE (PEWS) AS A TOOL FOR EARLY IDENTIFICATION OF SEPSIS: EVALUATING ITS ROLE IN IMPROVING OUTCOMES AND REDUCING MORBIDITY

Abstract

Pediatric sepsis is a major cause of morbidity and mortality in most parts of the world especially the low- and medium-income nations where delays in identification and intervention are prevalent. Preliminary diagnosis is important in the mitigation of negative effects, and the unspecific nature of sepsis usually complicates the issue of timely diagnosis. Pediatric Early Warning Score (PEWS) has been raised as a structured bedside instrument to predict early clinical deterioration in children, although its effect in sepsis-specific determination still needs to be empirically tested. This paper examined the validity, clinical implications, and the practicability of PEWS in the detection of pediatric sepsis in Karachi, Pakistan, tertiary hospitals. PEWS assessed a potential group of 100 children admitted in the hospitals with suspected infections both on admission and during the hospitalization. The diagnostic performance was ratiosed to clinical and lab gold standards. Results indicated that PEWS sensitivity was 83 percent, specificity value was 78 percent and area under the ROC (AU) was particularly high at 0.86, as well as negative predictive value. PEWS improved a detection rate, a reduction in inter-clinician variation, and a time-to-antibiotics mean of 42 minutes than that of clinician-only judgment. The clinical results were observed in the decreased stay in the intensive care unit by the margin of 2.8 days and reduced progression to septic shock among the cases identified by PEWS. Qualitative feedback provided by healthcare professionals regarding good aspects of structured assessment and confidence-building was also present, although barriers such as false positive, additional workload and training demand were also cited. The outcomes confirm the fact that PEWS is legitimate, feasible and context-relevant tool in the early-stage pediatric sepsis recognition, especially in low resource where it operates. Integration of PEWS into pediatric care practices, at a system level in combination with training and support, can significantly enhance early recognition and morbidity and result in better clinical outcomes in children at risk of sepsis.