Predictive score for clinical complications during intra-hospital transports of infants treated in a neonatal unit
AUTOR(ES)
Vieira, Anna Luiza Pires, Santos, Amélia Miyashiro Nunes dos, Okuyama, Mariana Kobayashi, Miyoshi, Milton Harumi, Almeida, Maria Fernanda Branco de, Guinsburg, Ruth
FONTE
Clinics
DATA DE PUBLICAÇÃO
2011
RESUMO
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.
Documentos Relacionados
- Antenatal treatment with corticosteroids for preterm neonates: impact on the incidence of respiratory distress syndrome and intra-hospital mortality
- ASSOCIAÇÃO ENTRE DEPRESSÃO, SÍNDROME CORONARIANA AGUDA E PROGNÓSTICO INTRA-HOSPITALAR.
- Quality of Intra-Hospital Nutritional Counseling in Patients with STEMI in the Public and Private Health Networks of Sergipe: The VICTIM Register
- A ATUAÇÃO DO ENFERMEIRO AUDITOR INTRA-HOSPITALAR NA MESORREGIÃO DO VALE DO ITAJAÍ
- NÍVEL DE ATIVIDADE FÍSICA E EVOLUÇÃO INTRA-HOSPITALAR DE PACIENTES COM SÍNDROME CORONARIANA AGUDA.