Predictive score for clinical complications during intra-hospital transports of infants treated in a neonatal unit

Predictive score for clinical complications during intra-hospital transports of infants treated in a neonatal unit

Author Vieira, Anna Luiza Pires Autor UNIFESP Google Scholar
Dos Santos, Amelia Miyashiro Autor UNIFESP Google Scholar
Okuyama, Mariana Kobayashi Autor UNIFESP Google Scholar
Miyoshi, Milton Harumi Autor UNIFESP Google Scholar
Almeida, Maria Fernanda Branco de Autor UNIFESP Google Scholar
Guinsburg, Ruth Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract OBJECTIVE: To develop and validate a predictive score for clinical complications during intra-hospital transport of infants treated in neonatal units. METHODS: This was a cross-sectional study nested in a prospective cohort of infants transported within a public university hospital from January 2001 to December 2008. Transports during even (n=301) and odd (n = 394) years were compared to develop and validate a predictive score. The points attributed to each score variable were derived from multiple logistic regression analysis. The predictive performance and the score calibration were analyzed by a receiver operating characteristic (ROC) curve and Hosmer-Lemeshow test, respectively. RESULTS: Infants with a mean gestational age of 35 + 4 weeks and a birth weight of 2457 + 841 g were studied. In the derivation cohort, clinical complications occurred in 74 (24.6%) transports. Logistic regression analysis identified five variables associated with these complications and assigned corresponding point values: gestation at birth [<28 weeks (6 pts); 28-34 weeks (3 pts); >34 weeks (2 pts)]; pre-transport temperature [<36.3°Cor >37°C(3pts); 36.3-37.0°C (2 pts)]; underlying pathological condition [CNS malformation (4 pts); other (2 pts)]; transport destination [surgery (5 pts); magnetic resonance or computed tomography imaging (3 pts); other (2 pts)]; and pre-transport respiratory support [mechanical ventilation (8 pts); supplemental oxygen (7 pts); no oxygen (2 pts)]. For the derivation and validation cohorts, the areas under the ROC curve were 0.770 and 0.712, respectively. Expected and observed frequencies of complications were similar between the two cohorts. CONCLUSION: The predictive score developed and validated in this study presented adequate discriminative power and calibration. This score can help identify infants at risk of clinical complications during intra-hospital transports.
Keywords Risk index
transportation of patients
infant newborn
neonatal intensive care units
risk factors
Language English
Date 2011-01-01
Published in Clinics. Faculdade de Medicina / USP, v. 66, n. 4, p. 573-577, 2011.
ISSN 1807-5932 (Sherpa/Romeo, impact factor)
Publisher Faculdade de Medicina / USP
Extent 573-577
Origin http://dx.doi.org/10.1590/S1807-59322011000400009
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000291312100009
SciELO ID S1807-59322011000400009 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/6258

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