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Predictive score for clinical complications during intra-hospital transports of infants treated in a neonatal unit
Vieira, Anna Luiza Pires; Santos, Amélia Miyashiro Nunes dos; Okuyama, Mariana Kobayashi; Miyoshi, Milton Harumi; Almeida, Maria Fernanda Branco de; Guinsburg, Ruth.
Afiliação
  • Vieira, Anna Luiza Pires; Federal University of São Paulo. Neonatal Division of Medicine. Department of Pediatrics. São Paulo. BR
  • Santos, Amélia Miyashiro Nunes dos; Federal University of São Paulo. Neonatal Division of Medicine. Department of Pediatrics. São Paulo. BR
  • Okuyama, Mariana Kobayashi; Federal University of São Paulo. Neonatal Division of Medicine. Department of Pediatrics. São Paulo. BR
  • Miyoshi, Milton Harumi; Federal University of São Paulo. Neonatal Division of Medicine. Department of Pediatrics. São Paulo. BR
  • Almeida, Maria Fernanda Branco de; Federal University of São Paulo. Neonatal Division of Medicine. Department of Pediatrics. São Paulo. BR
  • Guinsburg, Ruth; s.af
Clinics ; 66(4): 573-577, 2011. tab
Artigo em Inglês | LILACS | ID: lil-588906
Biblioteca responsável: BR1.1
ABSTRACT

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 percent) 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.
Assuntos


Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: LILACS Assunto principal: Unidades de Terapia Intensiva Neonatal / Transporte de Pacientes / Malformações do Sistema Nervoso Tipo de estudo: Estudo de etiologia / Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Feminino / Humanos / Lactente / Masculino Idioma: Inglês Revista: Clinics Assunto da revista: Medicina Ano de publicação: 2011 Tipo de documento: Artigo País de afiliação: Brasil Instituição/País de afiliação: Federal University of São Paulo/BR

Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: LILACS Assunto principal: Unidades de Terapia Intensiva Neonatal / Transporte de Pacientes / Malformações do Sistema Nervoso Tipo de estudo: Estudo de etiologia / Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Feminino / Humanos / Lactente / Masculino Idioma: Inglês Revista: Clinics Assunto da revista: Medicina Ano de publicação: 2011 Tipo de documento: Artigo País de afiliação: Brasil Instituição/País de afiliação: Federal University of São Paulo/BR
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