Usability of the Premature Newborn Clinical Assessment Scale (PNCAS) during pretransport preparation of newborns

Abstract

Purpose. To study the patient’s characteristics and hospital outcomes in subgroups depending on the PNCAS scale score.Material and methods. The cohort study included data from 604 trips of the transport team to newborns hospitalized in medical organizations of the Sverdlovsk region from August 1, 2017, to December 31, 2018. Median birth weight [IQR] 2515 [1600; 3275] grams, median gestational age [IQR] 36 [32; 38] weeks. The total sample was divided into subgroups depending on the assessment of the score, followed by a comparison of characteristics and outcomes in these subgroups.Results. There are significant differences in the structure of birth weight and gestational age, as the PNCAS score increases, there is a significant increase in the proportion of patients weighing less than 1000 grams and a decrease in the proportion of patients weighing 2500–3499 grams. The largest proportion of extremely premature newborns was observed in 6–8 points and 9–14 points subgroups, 30.16% and 24.00%, respectively. Assessment of the intensive care showed an increase in the proportion of patients requiring HFOV, dopamine and epinephrine infusion while increasing PNCAS score. Analysis of the outcomes showed a significant increase of mortality while increasing PNCAS score, 0.76% [0.02; 4.18] in the 0–2 points subgroup and 42.86% [21.82; 65.98] in the 9–14 points subgroup. There is also an increase in the proportion of patients who have formed severe IVH, 0.00% [0.00; 2.78] in the 0–2 points subgroup and 19.05% [5.45; 41.91] in the 9–14 points subgroup. A similar pattern is observed in the frequency of late onset sepsis.Conclusion. The PNCAS scale we studied demonstrates a reliable division of patients by severity and predicts the outcomes of the hospital stage of treatment.