Westley score and clinical factors in predicting the outcome of croup in the pediatric emergency department.

A total of 192 patients with croup were enrolled. Cyanosis and altered consciousness were not clinically significant even in patients with severe croup, whereas retraction and air entry were the major factors in WS for predicting clinical outcomes. The initial WS had a strong correlation with the length of hospital stay (r = 0.617, P < 0.001). ROC analysis showed that patients with an initial WS <2 (sensitivity, 5%; specificity, 100%; LR+ , 1.05; LR- , 0; AUC, 0.87) were discharged home while the patients with an initial WS ≥5 (sensitivity, 99%; specificity, 57%; LR+ , 41.0; LR- , 0.43) were more likely to require to stay in the PED. Patients with an WS ≥6 were more likely to be admitted to the wards (sensitivity, 97%; specificity, 47%; LR+ , 416.35; LR- , 0.54; AUC, 0.90) CONCLUSION: Patients with an initial WS of 1-2 could be safely treated at home and those with initial WS >5 required hospitalization for further treatment.