title: Factors predicting mortality in newborn ventilation.
abstract: OBJECTIVE
  Prediction of mortality among newborns on mechanical ventilation is difficult. Our aim was to develop a scoring system for predicting mortality among such neonates.
  
  
  METHODS
  This multi centre prospective study was performed to develop and validate a scoring system among two equal cohorts of ventilated newborns in India. Mechanical ventilator was used in pressure-limited time-cycled mode. Arterial blood gas, initial pulmonary pressures, septicemia screen along with other basic parameters were recorded in a pre-structured proforma. Blood samples were analyzed for malondialdehyde to determine the possible role and predictive validity of free radical injury. Multiple logistic regression analysis was done to find out independent predictors of mortality for the variables those were significantly associated with outcome after univariate analysis.
  
  
  RESULTS
  On univariate analysis, birth-weight, oxygenation-index, septicaemia, malondialdehyde level, and inotropic support were significantly associated with mortality. However, after multiple regression analysis gestational-age, pH and FiO2lost their significance as predictors. According to cut-off values of ROC-curve, a scoring system ranging from 0 to 20 and four mortality risk groups were developed. Area under ROC-curve was 0.94, compared to 0.90 for both APACHE-III and CRIB-scores; and 0.92 for PRISM-score.
  
  
  CONCLUSIONS
  Birth-weight, oxygenation-index, malondialdehyde level, inotropic support, and septicemia are independent mortality predictors of neonatal ventilation. Increase in malondialdehyde level is associated with higher mortality rate, indicating possible role of free radical injury. Pediatr Pulmonol. 2015; 50:271-275. © 2014 Wiley Periodicals, Inc.
authors.affiliation: Department of Pediatrics, NRS Medical College & Hospital, Kolkata, India.
authors.forename: Biswanath
authors.initials: B
authors.lastname: Basu
authors.affiliation: Department of Neonatal Paediatrics, James Cook University Hospital, University of Durham, Middlesbrough, UK.
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Sinha
authors.affiliation: Science College, Kolkata, India.
authors.forename: T
authors.initials: T
authors.lastname: Basu
authors.affiliation: Department of Pediatrics, RG Kar Medical College & Hospital, Kolkata, India.
authors.forename: T K S
authors.initials: TKS
authors.lastname: Mahapatra
keywords: malondialdehyde level; oxygenation-index