Comparison of mortality risk: a score for very low birthweight infants
Department of Neonatology, Virchow-Klinikum,
Humboldt-Universität, Augustenburger Platz 1, D-13353 Berlin,
Germany
Correspondence to: Dr Rolf Maier.
Accepted 19 November 1996
AIM
To develop and evaluate a score which
quantifies mortality risk in very low birthweight (VLBW) infants
(birthweight below 1500 g) at admission to the neonatal intensive care unit.
METHODSFive hundred and seventy two VLBW infants
admitted from 1978 to 1987 were randomly assigned to a cohort (n = 396)
for score development and a cohort (n = 176) for score
validation. Two hundred and ninety four VLBW infants admitted from 1988 to 1991 were used to compare risk adjusted mortality between the two eras.
RESULTSUsing multiple regression analysis,
birthweight, Apgar score at 5 minutes, base excess at admission,
severity of respiratory distress syndrome, and artificial ventilation
were predictive of death in the development cohort. According to
regression coefficients, a score ranging from 3 to 40 was developed. At
a cutoff of 21, it predicted death in the validation cohort with a
sensitivity of 0.85, a specificity of 0.73, and a correct
classification rate of 0.76. The area under the receiver operating
characteristic curve was 0.86. There was no significant difference in
risk severity and in risk adjusted mortality between the eras 1978-87
and 1988-91.
CONCLUSIONThe present score is robust, easily
obtainable at admission, and permits early randomisation based on
mortality risk.
© 1997 by Archives of Disease in Childhood
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