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Boston Children's Hospital Global Health

Detecting Early Warning Signs in Pediatric Cancer Patients

Detecting-early-warning-signsLOCATION: Guatemala
TOPIC: Non-Communicable Diseases, Education

As cancer treatment becomes more available around the world, hospitals face the combined challenge of caring for a high-risk population in a low-resource environment. There is an urgent need for an effective, low-cost method for early identification of patient deterioration as a way to improve inpatient outcomes and overall pediatric cancer survival. Hospitals frequently use Pediatric Early Warning Scores (PEWS), which are nurse-evaluated scores combining vital sign and exam findings associated with worsening clinical status, to identify patients at risk. Hospital implementation of PEWS has been shown to decrease severity of illness on ICU transfer, rates of cardiopulmonary arrests, and overall hospital mortality. These scores, however, have not been well studied in resource-limited settings.

Dr. Asya Agulnik has developed an Oncology Pediatric Early Warning Score (Onc-PEWS) that is adjustable to a hospital’s resource level. She is evaluating this score in Guatemala’s 60- bed pediatric oncology hospital, Unidad Nacional de Oncología Pediátrica (UNOP). The overall goal of this work is to develop a valid, effective, low cost and practical way to improve identification of clinical deterioration in these high-risk patients, and, as a result, lead to improved outcomes and lower mortality. Dr. Agulnik’s long-term goal is to expand the use of this tool, implementing it in pediatric oncology centers around the world including the Dominican Republic, Colombia, and Mexico. This newly developed tool has the potential to reduce inpatient mortality for pediatric oncology patients worldwide.