To develop a model to predict which newborns ≥34 weeks gestation with respira tory distress will die or will require prolonged ( > 3 days) assisted ventilatio n. Retrospective cohort study using data from Northern...To develop a model to predict which newborns ≥34 weeks gestation with respira tory distress will die or will require prolonged ( > 3 days) assisted ventilatio n. Retrospective cohort study using data from Northern California newborns ≥34 weeks gestation who presented with respiratory distress. We split the cohort int o derivation and validation datasets. Bivariate and multivariate data analyses w ere performed on the derivation dataset. After developing a simple score on the derivation dataset, we applied it to the original as well as to a second validat ion dataset from Massachusetts. Of 2276 babies who met our initial eligibility c riteria, 203 (9.3%) had the primary study outcome (assisted ventilation > 3 da ys or death). A simple score based on gestational age, the lowest PaO2/FIO2, a v ariable combining lowest pH and highest PaCO2, and the lowest mean arterial bloo d pressure had excellent performance, with a c-statistic of 0.85 in the deriva tion dataset, 0.80 in the validation dataset, and 0.80 in the secondary valida tion dataset. A simple objective score based on routinely collected physiologic predictors can predict respiratory outcomes in infants ≥34 weeks gestation with respiratory distress.展开更多
文摘To develop a model to predict which newborns ≥34 weeks gestation with respira tory distress will die or will require prolonged ( > 3 days) assisted ventilatio n. Retrospective cohort study using data from Northern California newborns ≥34 weeks gestation who presented with respiratory distress. We split the cohort int o derivation and validation datasets. Bivariate and multivariate data analyses w ere performed on the derivation dataset. After developing a simple score on the derivation dataset, we applied it to the original as well as to a second validat ion dataset from Massachusetts. Of 2276 babies who met our initial eligibility c riteria, 203 (9.3%) had the primary study outcome (assisted ventilation > 3 da ys or death). A simple score based on gestational age, the lowest PaO2/FIO2, a v ariable combining lowest pH and highest PaCO2, and the lowest mean arterial bloo d pressure had excellent performance, with a c-statistic of 0.85 in the deriva tion dataset, 0.80 in the validation dataset, and 0.80 in the secondary valida tion dataset. A simple objective score based on routinely collected physiologic predictors can predict respiratory outcomes in infants ≥34 weeks gestation with respiratory distress.
