Comparison of mortality risk: a score for very low birthweight infants.
OBJECTIVE
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.


METHODS
Five 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.


RESULTS
Using 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.


CONCLUSIONS
The present score is robust, easily obtainable at admission, and permits early randomisation based on mortality risk.
Maier
R F
RF
Department of Neonatology, Virchow-Klinikum, Humboldt-Universität, Berlin, Germany.
Rey
M
M
Metze
B C
BC
Obladen
M
M
D001034:Apgar Score; D001724:Birth Weight; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D008297:Male; D010808:Physical Examination; D011237:Predictive Value of Tests; D012044:Regression Analysis; D015203:Reproducibility of Results; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis; D012307:Risk Factors