Emergency Department Pediatric Early Warning System for Identifying Resuscitation-Defined Critical Illness in Children: A Prospective Diagnostic Classification Study in Vietnam

Background/Objectives: Early recognition of children with severe physiological illness is essential in emergency care. The Emergency Department Pediatric Early Warning System score (ED-PEWS) has not been evaluated in Vietnam. We assessed how well ED-PEWS recorded at presentation identifies children who meet criteria for resuscitation-defined critical illness in a high-acuity pediatric emergency setting.

Methods

This prospective observational diagnostic classification study was conducted from August to October 2022 in the emergency and resuscitation department of a national tertiary children’s hospital in Vietnam. Children aged 1 month to 15 years were enrolled according to a prespecified shift-based schedule. The outcome was resuscitation-defined critical illness within 24 h (cardiac arrest or bradycardia with poor perfusion requiring cardiopulmonary resuscitation). Because the timing of scoring relative to interventions and outcome was not recorded, the analysis was interpreted as concurrent classification rather than prediction.