持续性肺高血压新生儿的死亡率预测:比较四种疾病严重性得分
Pattima Pakhathirathien1, Gunlawadee Maneenil1, Anucha Thatrimontrichai1
1Department of Pediatrics, Division of Neonatology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
Pediatric pulmonology
|January 14, 2025
概括
72小时的氧化指数 (OI72max) 最好预测新生儿持续性肺高血压 (PPHN) 的死亡率. 其他评分如OI48max,SNAPPE-II和VIS72max也显示了PPHN死亡率预测的良好准确性.
科学领域:
- 新生儿医学 新生儿医学
- 儿科重症监护 儿科重症监护
- 医疗信息学 医疗信息学
背景情况:
- 新生儿持续性肺高血压 (PPHN) 是一种严重的疾病,需要准确的预后工具.
- 评估疾病严重程度得分对于及时有效地管理患有PPHN的新生儿至关重要.
研究的目的:
- 为了比较四个新生儿疾病严重性得分在PPHN中的死亡率的预测准确度.
- 确定在PPHN管理中指导临床决策的最有效得分.
主要方法:
- 对146名被诊断患有PPHN的新生儿 (2013-2022) 的回顾性分析.
- 对婴儿的临床风险指数II (CRIB-II) 的评估,新生儿急性生理学-产前延伸版本II (SNAPPE-II) 的评分,最大氧化指数 (OI) 和各种时间点的血管活性-内热性评分 (VIS).
- 接收器操作特征 (ROC) 曲线分析以确定精度和最佳切断值.
主要成果:
- 72小时的氧化指数 (OI72max) 在预测死亡率方面表现出最高的准确性 (AUC:0.88).
- OI48max (AUC:0.86),VIS72max (AUC:0.80) 和SNAPPE-II (AUC:0.84) 也显示出显著的预测能力.
- 与幸存者相比,没有幸存者的CRIB-II,SNAPPE-II,最大OI和VIS分数明显更高.
结论:
- 在PPHN中,OI72max是预测死亡率的最准确得分.
- OI48max,SNAPPE-II和VIS72max提供了有价值的预后信息.
- 利用这些验证的分数可以促进早期管理策略,并加强患者监测,以改善结果.
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