Early Heart Rate Characteristics Predict Death and Morbidities in Preterm Infants - 24/06/16
Abstract |
Objectives |
To determine whether an early heart rate characteristics (HRC) index (HeRO score), measured in the first day and week after birth predicts death and morbidities compared with established illness severity scores.
Study design |
For all very low birth weight infants in a single neonatal intensive care unit from 2004-2014, the average first day HRC index was calculated within 24 hours of birth (aHRC-24h) and the average first week HRC index within 7 days of birth (aHRC-7d). The Score for Neonatal Acute Physiology (SNAP-II) and Clinical Risk Indicator for Babies (CRIB-II) were calculated when data were available. The aHRC was compared with the SNAP-II and CRIB-II for predicting death, late-onset septicemia, necrotizing enterocolitis, bronchopulmonary dysplasia, severe intraventricular hemorrhage, or severe retinopathy of prematurity.
Results |
All 4 scores were associated with death and severe intraventricular hemorrhage (P < .01). The OR and 95% CI for every 1-point increase in aHRC for predicting mortality, adjusted for gestational age, was 1.59 (1.25-2.00) for aHRC-24h and 2.61 (1.58-4.33) for aHRC-7d. High aHRC-7d, SNAP-II, and CRIB-II were associated with bronchopulmonary dysplasia (P < .001). High aHRC-7d was associated with late-onset septicemia (P < .05). None of the scores predicted necrotizing enterocolitis or severe retinopathy of prematurity.
Conclusions |
HRC assessed in the first day or first week after birth compares favorably to established risk scores to predict death and morbidities in very low birth weight infants.
Le texte complet de cet article est disponible en PDF.Keywords : heart rate characteristics, very low birth weight infants, illness severity score, septicemia, intraventricular hemorrhage, bronchopulmonary dysplasia, SNAP, CRIB
Abbreviations : aHRC-7d, aHRC-24h, AUC, BPD, CRIB-II, ECG, GA, HRC, IVH, LOS, NEC, NICU, NRI, ROC, ROP, SNAP-II, UVA, VLBW
Plan
Funded by the National Institutes of Health (R01 HD072071-02). D.L. and J.M. have equity shares in Medical Predictive Science, which had no input into study design, data analysis, or manuscript preparation. The other authors declare no conflicts of interest. |
Vol 174
P. 57-62 - juillet 2016 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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