ABSTRACT 972

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Background and aims: Unplanned Pediatric Intensive Care Unit (PICU) readmission is associated with greater length of ICU stay and mortality. Identifying children at risk of ICU readmission will enable earlier interventions for high-risk populations. The Pediatric Early Warning Score (PEWS), developed to identify children at risk of clinical deterioration, combines risk factors found previously to be associated with unplanned PICU readmission. Aims: Our primary aim is to evaluate association of PEWS with unplanned PICU readmission. Methods: Institutional Review Board approval included waiver of informed consent for this single-center case-control study. Children ≤ 18 years transferred from the PICU to the Pediatric Ward from 1/10 to 3/13 were screened. Cases had unplanned PICU readmission within 48 hours of transfer. Controls were not readmitted. PEWS scores assigned in the PICU (≤4 hours prior to transfer) and first PEWS scores assigned on the Pediatric Ward (≤4 hours after transfer) were collected for cases and controls. Multivariate logistic regression was used to generate odds ratios and 95% confidence intervals and test association of PEWS with unplanned PICU readmission, adjusted for age. Results: PEWS prior to PICU discharge and first PEWS on the Pediatric Ward were higher for readmitted vs. non-readmitted patients [median(IQR), 2(1,3) vs. 1(1,2);P=0.005] and [2(2,3) vs. 1(1,2);P=0.005], respectively. PEWS prior to PICU discharge and first PEWS on the Pediatric Ward were significantly associated with PICU readmission [adjusted OR (95%CI), 2.2(1.3-3.5);P=0.002] and [2.4(1.5-4.0);P<0.001], respectively. Conclusions: PEWS prior to PICU discharge and first PEWS on the Pediatric Ward can help identify children at high risk of PICU readmission.