Key messages? Evaluation of clinical data from 2,074 patients in four paediatric hospitals showed that the Bedside PEWS score could identify children at risk of cardiac arrest with at least one hour’s notice.? After inclusion selleckchem 17-AAG of the data from the hour immediately before near or actual cardiopulmonary arrest events, the AUCROC (95% CI) curve increased from 0.87 (0.85 to 0.89) to 0.88 (0.87 to 0.90).? Bedside PEWS reflected evolving critical illness. Scores increased over the 24 hours before near or actual cardiopulmonary arrest events.? The retrospective opinion of nurses caring for the patients studied was inferior to the Bedside PEWS score (P < 0.0001).? Evaluation of the effect of the Bedside PEWS score on important clinical outcomes is required.

AbbreviationsAUCROC: area under the receiver operating characteristic curve; Bedside PEWS: Bedside Paediatric Early Warning System.Competing interestsCSP and KM are the named inventors of the Bedside Paediatric Early Warning System. US and European patents are pending. As of April 2011, CSP and KM owned stock in Bedside Clinical Systems, a Clinical Decision Support company. The activities of this company include development of an electronic form of the Bedside Paediatric Early Warning System, of which the Bedside PEWS score is a component.Authors’ contributionsCSP conceived of the study, contributed to its design, oversaw data acquisition, contributed to data analysis, wrote the initial draft of the manuscript and contributed to subsequent manuscript revisions.

HPD, ARJ, CAF, JRL, KLM and JSH each contributed to the design of the study, contributed to data acquisition at their respective hospitals and contributed to manuscript revisions. PCP and DW contributed to the study design and manuscript revisions. JB contributed to the study design and analysis. NB contributed to study analysis and manuscript revisions. All authors read and approved the final manuscript.AcknowledgementsThis work was in part supported by funds from the Heart and Stroke Foundation and the Centre for Safety Research at the Hospital for Sick Children. CSP is a career scientist at the Ontario Ministry of Health and Long-Term Care and recipient of an Early Researcher Award from the Ontario Ministry of Research and Innovation.
Stroke is a major cause of morbidity and one of the leading causes of death worldwide [1].

Atherothrombosis and inflammation play important roles in the pathogenesis of acute ischemic stroke [2-4]. A previous study demonstrates that platelet activity, measured by CD62P and CD63 expressions on platelets, are increased after acute ischemic stroke and reduced in patients who receive anti-platelet therapy [5-7]. Anti-platelet drugs are the most commonly Drug_discovery used drugs for secondary prevention after ischemic stroke of non-cardio-embolic origin [8], but their efficacy is not completely satisfactory [9,10].