title: Predictive score for clinical complications during intra-hospital transports of infants treated in a neonatal unit.
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%) 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatrics, Neonatal Division of Medicine, Federal University of São Paulo, SP, Brazil.
authors.forename: Anna Luiza Pires
authors.initials: AL
authors.lastname: Vieira
authors.forename: Amélia Miyashiro Nunes dos
authors.initials: AM
authors.lastname: Santos
authors.forename: Mariana Kobayashi
authors.initials: MK
authors.lastname: Okuyama
authors.forename: Milton Harumi
authors.initials: MH
authors.lastname: Miyoshi
authors.forename: Maria Fernanda Branco de
authors.initials: MF
authors.lastname: Almeida
authors.forename: Ruth
authors.initials: R
authors.lastname: Guinsburg
mesh_terms: D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007223:Infant; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D008297:Male; D009421:Nervous System Malformations / Q000150:complications*; D018570:Risk Assessment / Q000379:methods; D014187:Transportation of Patients / Q000592:standards*