Document Detail


Predictive score for clinical complications during intra-hospital transports of infants treated in a neonatal unit.
MedLine Citation:
PMID:  21655749     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Anna Luiza Pires Vieira; Amélia Miyashiro Nunes dos Santos; Mariana Kobayashi Okuyama; Milton Harumi Miyoshi; Maria Fernanda Branco de Almeida; Ruth Guinsburg
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Publication Detail:
Type:  Journal Article; Validation Studies    
Journal Detail:
Title:  Clinics (São Paulo, Brazil)     Volume:  66     ISSN:  1980-5322     ISO Abbreviation:  Clinics (Sao Paulo)     Publication Date:  2011  
Date Detail:
Created Date:  2011-06-09     Completed Date:  2011-12-28     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  101244734     Medline TA:  Clinics (Sao Paulo)     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  573-7     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Neonatal Division of Medicine, Federal University of São Paulo, SP, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Epidemiologic Methods
Female
Humans
Infant
Intensive Care Units, Neonatal / statistics & numerical data*
Male
Nervous System Malformations / complications*
Risk Assessment / methods
Transportation of Patients / standards*
Comments/Corrections

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