A Comparison of Neonatal Mortality Risk Prediction Models in Very Low Birth Weight Infants

Pollack, Murray M.; Koch, Matthew; Bartel, Doris; Rapoport, Irina; Dhanireddy, Ramasubbareddy; El-Mohandes, Ayman; Harkavy, Kenneth L.; Subramanian, K. N. Siva

doi:10.1542/peds.105.5.1051

Cited by 112 publications

(85 citation statements)

References 29 publications

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“…The NICHD score was developed in the United States (n ¼ 3603 infants 501 to 1500 g) 17 although with occasional poor performance and no better than birth weight alone. 18,19 In recent years, Pollack et al 20 has published risk models in a cohort of VLBW infants from the Washington, DC area. They found that these scores overpredicted mortality indicating a need for frequent recalibration.…”

Section: Discussionmentioning

confidence: 99%

A New Score for Predicting Neonatal Very Low Birth Weight Mortality Risk in the NEOCOSUR South American Network

et al. 2005

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in infants with birth weight 500 to 1500 g were employed. A testing sample and crossvalidation techniques were used to validate a statistical model for risk of in-hospital mortality. The new risk score was compared with two existing scores by using area under the receiver operating characteristic curve (AUC). RESULTS:The new NEOCOSUR score was highly predictive for in-hospital mortality (AUC ¼ 0.85) and performed better than the Clinical Risk Index for Babies (CRIB) and the NICHD risk models when used in the NEOCOSUR Network. The new score is also well calibrated F it had good predictive capability for in-hospital mortality at all levels of risk (HL test ¼ 11.9, p ¼ 0.85). The new score also performed well when used to predict in hospital neurological and respiratory complications. CONCLUSIONS:A new and relatively simple VLBW mortality risk score had a good prediction performance in a South American network population. This is an important tool for comparison purposes among NICUs. This score may prove to be a better model for application in developing countries.

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Section: Discussionmentioning

confidence: 99%

A New Score for Predicting Neonatal Very Low Birth Weight Mortality Risk in the NEOCOSUR South American Network

et al. 2005

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“…Our results showed that all risk factors analyzed except low birth weight were associated with infection by GNB when compared with colonized neonates. Very low birth weight has been recognized as a factor that predicts neonatal mortality with good discrimination (1,18). In other Brazilian studies (11,14) birth weight, prematurity, low gestational age, mechanical ventilation, total parenteral nutrition, vascular/umbilical catheter, intubation in the delivery room and the use of antibiotics were considered as risk factors associated with nosocomial infections in NICU.…”

Section: Discussionmentioning

confidence: 99%

Infection and colonization by Gram-negative bacilli in neonates hospitalized in High Risk Nursery at Uberlandia Federal University Hospital: etiology, resistant phenotypes and risk factors

Cezário¹,

Ribas²,

Abdallah³

et al. 2004

Braz. J. Microbiol.

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The aims of this study were to determine endemic and epidemic infection due to Gram-negative bacilli, risk factors associated with colonization and infection by these organisms and the resistance phenotypes (ESBL, AmpC) in neonates admitted in a High Risk Nursery. The study was conducted during a 21 month period and included: a prospective study to evaluate the neonates with hospital infection and the use of third-generation cephalosporins; a case-control study to determine the risk factors associated with colonization/infection. Rectal and oropharynx cultures were also performed in four opportunities (September and November 2001, February and August 2002). The isolates for which the resistance of ceftazidime was 2 µg/mL were suspected of producing ESBL or AmpC β-lactamases. The incidence of infection by Gram-negative bacilli was 2.4% (89/ 3.708 neonates), and sepsis (35.9%) and conjunctivitis (31.4%) were the most common infections. The endemic infections were more prevalent (73.9%) and usually associated with Enterobacteriaceae (95.5%), being these organisms also related to colonization, corresponding mainly to isolates of Enterobacter spp. and Klebsiella spp. Two outbreaks of Pseudomonas aeruginosa (n=10) and Acinetobacter baumannii (n=11) were identified during the survey. Univariate analysis showed that risk factors for Gram-negative bacilli infection considered significant included: the length of stay before infection/colonization, exposure to antimicrobial agents, mechanical ventilation, central venous catheters, parenteral nutrition and surgery. The majority of resistance to ceftazidime among Enterobacteriaceae isolates (80.9%) was from ESBL phenotype. Administration of thirdgeneration cephalosporins (ceftriaxone) led to the emergence of these multiresistant Gram-negative bacilli in the neonatal unit.

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“…Os dados disponíveis ao nascimento, como o peso de nascimento e baixo escore de Apgar no 5° minuto de vida, assumiram particular importância, e dentre os escores, o melhor marcador seria o SNAP-PE. Dessa forma, estudos que avaliam, por exemplo, a sobrevida de recém-nascidos submetidos à ventilação mecânica têm utilizado o SNAP-PE como escore padrão 14,15 .…”

Section: Discussionunclassified

“…[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50], higher than 50 (mortality: 3%, 10%, 53%, 78%, 83%, respectively). The optimal cut off points based on ROC curve were 12 for SNAP, and 24 for SNAP-PE.…”

Section: Introductionmentioning

confidence: 99%

Valor preditivo dos escores de SNAP e SNAP-PE na mortalidade neonatal

Silveira

Schlabendorff²,

Procianoy

2001

J. Pediatr. (Rio J.)

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ResumoObjetivos: avaliar os escores SNAP e SNAP-PE como preditores de mortalidade neonatal na nossa UTI neonatal, comparando seus resultados.Métodos: todos os recém-nascidos admitidos na UTI neonatal no período de março de 1997 a dezembro de 1998 foram avaliados prospectivamente quanto ao SNAP e SNAP-PE com 24 horas de vida. Foram critérios de exclusão o óbito ou alta da UTI nas primeiras 24 horas de vida, as malformações congênitas incompatí-veis com a vida, e recém-nascidos transferidos de outros hospitais.Resultados Methods: All newborn infants admitted to our neonatal intensive care unit from March 1997 through December 1998 were prospectively evaluated just at completion of 24 hours of life for SNAP and SNAP-PE. Exclusion criteria were: death or discharge from the neonatal intensive care unit in the first 24 hours of life, congenital malformations incompatible with life, and outborn infants.Results: 553 newborn infants were included in the study and 54 died. The median SNAP and SNAP-PE values were higher in those who died. Infants were allocated to five different raising ranges of SNAP and SNAP-PE severity.SNAP: up to 6, 7-11, 12-15, 16-24, higher than 24 (mortality: 3%, 11%, 29%, 48%,75%, respectively). [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50], higher than 50 (mortality: 3%, 10%, 53%, 78%, 83%, respectively). The optimal cut off points based on ROC curve were 12 for SNAP, and 24 for SNAP-PE. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for death were figured out. SNAP 12: sensitivity 79.6%, specificity 71.7%, PPV 23.4%, NPV 97%. SNAP-PE 24: sensitivity 79.6%, specificity 80%, PPV 30%, NPV 97.3%. The area under the curve (Az) were 81.4% for SNAP, and 85.1% for SNAP-PE, both statistically significant. There were no statistical differences between the two areas under the curve.Conclusions: SNAP and SNAP-PE are excellent predictors of neonatal survival. Therefore, we recommend their use in Neonatal Intensive Care Units.J Pediatr (Rio J) 2001; 77 (6): 455-60 IntroduçãoO baixo peso de nascimento foi classicamente descrito na literatura como o maior determinante da mortalidade neonatal em 1930, quando acreditava-se que recém-nascidos pesando 2.500g ou menos apresentavam um risco

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A Comparison of Neonatal Mortality Risk Prediction Models in Very Low Birth Weight Infants

Cited by 112 publications

References 29 publications

A New Score for Predicting Neonatal Very Low Birth Weight Mortality Risk in the NEOCOSUR South American Network

A New Score for Predicting Neonatal Very Low Birth Weight Mortality Risk in the NEOCOSUR South American Network

Infection and colonization by Gram-negative bacilli in neonates hospitalized in High Risk Nursery at Uberlandia Federal University Hospital: etiology, resistant phenotypes and risk factors

Valor preditivo dos escores de SNAP e SNAP-PE na mortalidade neonatal

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