Affiliation:
1. Ural State Medical University
2. Ural State Medical University;
Regional Children’s hospital
Abstract
Purpose. This study is aimed at determining the predictive value of the clinical assessment scale for premature newborns during pre-transport preparation in relation to the outcomes of treatment of newborns.Materials and methods. The cohort study included data from 604 visits of the neonatal transport team to the newborn children hospitalized in the medical centers 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. Primary medical documentation was used for scale assessment. Descriptive statistics tools: median and interquartile range, fraction, 95% CI for the proportion, error of the proportion, calculation of the area under the ROC curve, calculation of sensitivity, specificity, cut-off level, positive (PPV) and negative predictive value (NPV). The correlation analysis of quantitative data with an abnormal distribution is performed by Spearman’s test.Results. The scale demonstrated a high predictive value for lethal outcome (AUC = 0.803 (0.734–0.872)), 7-day mortality (AUC = 0.821 (0.743–0.899)), late neonatal sepsis (AUC = 0.763 (0.697–0.830)), severe intraventricular hemorrhage (AUC = 0.784 (0.729–0.838)), and occlusive hydrocephalus (AUC = 0.802 (0.725–0.878)) in the total sample of newborns (fullterm and premature). The negative predictive value significantly prevails over the positive predictive value. Weak correlations were found between the score and the duration of intensive care (r = 0.305, p < 0.0001), duration of ventilation (r = 0.221, p >< 0.0001), duration of nCPAP (r = 0.214, p = 0.001), and hospitalization (r = 0.214, p >< 0.0001), both in the general sample and among the survivors. Conclusion. The scale has a high predictive value in relation to the outcomes of the hospital stage in newborns, but a weak correlation with quantitative outcomes. Key words: Newborns, interhospital transportation of newborns, neonatal transfer, severity assessment, tactical decision.>˂ 0.0001), duration of ventilation (r = 0.221, p ˂ 0.0001), duration of nCPAP (r = 0.214, p = 0.001), and hospitalization (r = 0.214, p ˂ 0.0001), both in the general sample and among the survivors.Conclusion. The scale has a high predictive value in relation to the outcomes of the hospital stage in newborns, but a weak correlation with quantitative outcomes.
Publisher
The National Academy of Pediatric Science and Innovation
Subject
Pediatrics, Perinatology and Child Health
Reference15 articles.
1. Gould J.B., Danielsen B.H., Bollman L., Hackel A., Murphy B. Estimating the quality of neonatal transport in California. J Perinatol 2013; 33(12): 964-970. DOI: 10.1038/jp.2013.57
2. Aleksandrovich Yu.S., Gordeev V.I. Evaluation and prognostic scales in critical care medicine. Sankt-Peterburg: Sotis, 2007; 140. (in Russ.)
3. Bushtyrev V.A., Laura N.B., Zakharova I.I. Score assessment of the health status of premature newborns with perinatal infections. Rossiyskiy Vestnik Perinatologii i Pediatrii 2006; 51(3): 11-15. (in Russ.)
4. Bushtyrev V.A., Budnik V.A., Kuznetsova N.B. Criteria for the transportability of premature newborns. Akusherstvo i ginekologiya 2015; 7: 74-77. (in Russ.)
5. Bushtyrev V.A., Zemlyanskaya N.V., Petrenko Yu.V. Transportation needs rules. StatusPraesens. Pediatriya i neonatologiya 2017; 1(36): 71-75. (in Russ.)