The effectiveness of modified pediatric early warning score and modified pediatric risk of hospital admission score II in patients applying to the pediatric emergency unit during pandemic period associated with COVID-19 disease

Objective: Evaluation tools using vital signs and physiological parameters were developed in order to determine the clinical course of the patients admitted to the pediatric emergency unit and the critically ill child. This study aimed to evaluate the effectiveness of the Modified Pediatric Early Warning Score (MPEUS) and Modified Pediatric Hospitalization Risk Score II (MPRISA II) in patients who applied to the emergency department during the COVID-19 pandemic, and to determine critical children in the early period based on these scaling, and to investigate the detectability of patients who will be hospitalized in other inpatient units with the Pediatric Intensive Care Unit (PICU). Materials and Methods: Children aged between 28 days and 18 years who applied to Karadeniz Technical University Hospital Pediatric Emergency Department between February 1, 2021 and July 31, 2021 were included in our study. Patients admitted to the Emergency Observation Unit (AGB) were evaluated with MPEUS until their discharge, and patients admitted to the ward within the first 24 hours. If the patient was admitted to the PICU, scoring was not continued. On the other hand, MPRISA II was administered to patients only at the begining of admission. Results: A total of 935 patients were included in the study, 65% of these patients were followed in the AGB, 33% were hospitalized in pediatrics or other services, and 1.8% were hospitalized in the PICU. While the initial MPEUS was above 3, the sensitivity and specificity of MPEUS in predicting hospitalization was 17.80% and 92% (p=0,003). While the MPRISA II value was above 4, the sensitivity of MPRISA II in predicting hospitalization was 76.90% and its specificity was 45.80% (p<0,001). In addition, if the initial MPEUS was above 3, the sensitivity and specificity of MPEUS were 76.50% and 89.80% in predicting admission to the PICU (p<0,001). While the MPRISA II value was above 4, the sensitivity and specificity of MPRISA II were 93.75% and 38.45% in predicting admission to the PICU (p=0,004). Conclusion: It is understood that the values of MPEUS above 3 and MPRISA II above 4 in the baseline can predict hospitalization in the PICU, therefore, these scalings can predict critically ill patients with a remarkable performance, and this result is compatible with other studies before the pandemic period. For this reason, it can be thought that these evaluation tools can be used during the COVID-19 pandemic period and may be a promising tool for recognizing critically ill children in other pandemic periods.