母婴同室新生儿常见感染性疾病早期预警评估表的效度研究

Validity of Early Warning Assessment for Common Infectious Diseases of Mother-Newborns

目的回顾性分析评价母婴同室新生儿常见感染性疾病早期预警评估表效度,其对新生儿感染性疾病病情变化评估的作用。方法随机选取2018年1月至12月我院由母婴同室转入新生儿科治疗的常见感染性疾病新生儿140例为试验组,选取非感染性疾病新生儿138例为对照组。参考现行的新生儿早期预警评估表(NEW)设计母婴同室新生儿常见感染性疾病早期预警评估表(NIEW)。采用受试者工作特性曲线(ROC曲线)确定NIEW识别病情恶化需转入新生儿科患儿的最佳界值,计算其敏感度、特异度,并和现行的NEW评分结果进行比较。结果试验组NIEW评分为[4(3,5)],对照组得分为[0(0,1)],差异有统计学意义(P<0.05)。NIEW在识别病情恶化需转入新生儿科患儿的最佳界值是1.5,且相对于现行的NEW,两者间的ROC曲线下面积差异显著(0.971 vs. 0.871)。结论 NIEW能更准确识别出病情变化需通知医生或转入新生儿科的感染性疾病新生儿,与NEW相比具有较高的敏感性,值得临床进一步推广。

Objective To retrospectively analyze and evaluate validity of early warning assessment for common infectious diseases of mother-newborns,and its effect on changes based on neonatal infectious diseases.Methods From January to December 2018,140 newborns with common infectious diseases who were transferred from the same room to neonatal department in our hospital were selected as experimental group(EG),and 138 newborns with non-infectious diseases were selected as control group(CG).Based on current newborn early warning scores(NEW),newborn infection early warning scores(NIEW) was designed.Receiver operating characteristic curve(ROC curve) was used to determine the best cut-off value for NIEW to recognize disease deterioration that transferred to neonatology department,its sensitivity and specificity were calculated,and current NEW score results were compared.Results NIEW score of EG was[4(3,5) ]and score of CG was[0(0,1) ]with statistically significant difference(P<0. 05).The best cut-off value of NIEW was 1. 5 for identifying newborns transferred to neonatology department.Compared with current NEW,the area under ROC curve was significantly different(0. 971 vs. 0. 871).Conclusion NIEW could more accurately identify newborns with infectious diseases who need to notify doctors or transfer to neonatology department.Compared with NEW,it has a higher sensitivity and is worthy of further clinical promotion.