Respiratory parameters as a predictor of hospital outcomes in newborns requiring medical evacuation

Abstract

BACKGROUND: Assessment of the clinical condition, prediction of risks and possible outcomes during the transfer of newborns remains an important part of the work of transport teams. Respiratory disorders remain a significant indication for transfer to medical organizations of a higher level of care. AIM: To study the predictive value of the parameters of respiratory support in newborns requiring medical evacuation for the outcomes of treatment. MATERIALS AND METHODS: The observational, cohort, retrospective study included data from neonatal to patients on ventilators (286 newborns) in the period from August 1, 2017 to December 31, 2018. Anamnesis parameters, intensive care volume, respiratory support settings, and assessments on scales (KSHONN, NTISS, TRIPS) were evaluated. Analyzed: 24-hours mortality, 7 days mortality, hospital mortality, air leakage syndrome. The assessment and comparison of the predictive value of the parameters in relation to the hospital outcomes was performed. RESULTS: The AUC ROC of SpO2/FiO2 for predicting 24-hours mortality was 0.984 [0.9661.000], which is significantly higher than the ROC of the saturation oxygenation index (AUC 0.972 [0.9490.995], p = 0.004). The area under the ROC of the 24-hours mortality on the TRIPS scale does not significantly differ from the saturation index of oxygenation (AUC 0.972 [0.9490.995], p = 0.113) and the mean airway pressure (AUC 0.943 [0.8841.000], p = 0.107). When predicting 7-day mortality, the saturation oxygenation index has AUC ROC (0.702 [0.5490.854]) significantly lower than AUC ROC for SpO2/FiO2 (0.762 [0.6380.887], p = 0.001). SpO2/FiO2 predicts total mortality with AUC ROC (0.759 [0.6770.841]). CONCLUSIONS: The mean airway pressure, saturation oxygenation index and SpO2/FiO2 have a high (AUC 0,9) predictive value for 24-hours mortality, while only SpO2/FiO2 reliably predicts total mortality with AUC ROC 0,7.