Richardson score predicts short-term adverse respiratory outcomes in newborns >/=34 weeks gestation.
OBJECTIVE
To develop a model to predict which newborns >/=34 weeks gestation with respiratory distress will die or will require prolonged (>3 days) assisted ventilation.


METHODS
Retrospective cohort study using data from Northern California newborns >/=34 weeks gestation who presented with respiratory distress. We split the cohort into derivation and validation datasets. Bivariate and multivariate data analyses were performed on the derivation dataset. After developing a simple score on the derivation dataset, we applied it to the original as well as to a second validation dataset from Massachusetts.


RESULTS
Of 2276 babies who met our initial eligibility criteria, 203 (9.3%) had the primary study outcome (assisted ventilation >3 days or death). A simple score based on gestational age, the lowest PaO 2 /FIO 2 , a variable combining lowest pH and highest PaCO 2 , and the lowest mean arterial blood pressure had excellent performance, with a c-statistic of 0.85 in the derivation dataset, 0.80 in the validation dataset, and 0.80 in the secondary validation dataset.


CONCLUSIONS
A simple objective score based on routinely collected physiologic predictors can predict respiratory outcomes in infants >/=34 weeks gestation with respiratory distress.
Escobar
Gabriel J
GJ
Kaiser Permanente Medical Care Program, Division of Research, Perinatal Research Unit, Oakland, California, USA. Gabriel.Escobar@kp.org
Shaheen
Susan M
SM
Breed
Emily M
EM
Botas
Carlos
C
Greene
John D
JD
Yoshida
Cathleen K
CK
Zupancic
John
J
Newman
Thomas B
TB
D045422:Continuous Positive Airway Pressure; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D011237:Predictive Value of Tests; D012127:Respiratory Distress Syndrome, Newborn / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies