title: The Thompson Encephalopathy Score and Short-Term Outcomes in Asphyxiated Newborns Treated With Therapeutic Hypothermia.
abstract: The Thompson encephalopathy score is a clinical score to assess newborns suffering from perinatal asphyxia. Previous studies revealed a high sensitivity and specificity of the Thompson encephalopathy score for adverse outcomes (death or severe disability). Because the Thompson encephalopathy score was developed before the use of therapeutic hypothermia, its value was reassessed.
  
  
  
  The purpose of this study was to assess the association of the Thompson encephalopathy score with adverse short-term outcomes, defined as death before discharge, development of severe epilepsy, or the presence of multiple organ failure in asphyxiated newborns undergoing therapeutic hypothermia.
  
  
  
  The study period ranged from November 2010 to October 2014. A total of 12 tertiary neonatal intensive care units participated. Demographic and clinical data were collected from the "PharmaCool" multicenter study, an observational cohort study analyzing pharmacokinetics of medication during therapeutic hypothermia. With multiple logistic regression analyses the association of the Thompson encephalopathy scores with outcomes was studied.
  
  
  
  Data of 142 newborns were analyzed (male: 86; female: 56). Median Thompson score was 9 (interquartile range: 8 to 12). Median gestational age was 40 weeks (interquartile range 38 to 41), mean birth weight was 3362 grams (standard deviation: 605). All newborns manifested perinatal asphyxia and underwent therapeutic hypothermia. Death before discharge occurred in 23.9% and severe epilepsy in 21.1% of the cases. In total, 59.2% of the patients had multiple organ failure. The Thompson encephalopathy score was not associated with multiple organ failure, but a Thompson encephalopathy score ≥12 was associated with death before discharge (odds ratio: 3.9; confidence interval: 1.3 to 11.2) and with development of severe epilepsy (odds ratio: 8.4; confidence interval: 2.5 to 27.8).
  
  
  
  The Thompson encephalopathy score is a useful clinical tool, even in cooled asphyxiated newborns. A score ≥12 is associated with adverse outcomes (death before discharge and development of severe epilepsy). The Thompson encephalopathy score is not associated with the development of multiple organ failure.
authors.affiliation: Department of Neonatology, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Patricia
authors.initials: P
authors.lastname: Thorsen
authors.affiliation: Pediatric Clinical Research Office, Woman-Child Department, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Martine C
authors.initials: MC
authors.lastname: Jansen-van der Weide
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Floris
authors.initials: F
authors.lastname: Groenendaal
authors.affiliation: Department of Neonatology, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Wes
authors.initials: W
authors.lastname: Onland
authors.affiliation: Department of Neonatology, Isala, Zwolle, The Netherlands.
authors.forename: Henrika L M
authors.initials: HL
authors.lastname: van Straaten
authors.affiliation: Department of Neonatology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Inge
authors.initials: I
authors.lastname: Zonnenberg
authors.affiliation: Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Jeroen R
authors.initials: JR
authors.lastname: Vermeulen
authors.affiliation: Department of Neonatology, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Dijk
authors.affiliation: Department of Neonatology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Dudink
authors.affiliation: Department of Neonatology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Monique
authors.initials: M
authors.lastname: Rijken
authors.affiliation: Department of Neonatology, Radboud Medical Center, Nijmegen, The Netherlands.
authors.forename: Arno
authors.initials: A
authors.lastname: van Heijst
authors.affiliation: Department of Neonatology, Maxima Medical Center Veldhoven, Veldhoven, The Netherlands.
authors.forename: Koen P
authors.initials: KP
authors.lastname: Dijkman
authors.affiliation: Department of Neonatology, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Filip
authors.initials: F
authors.lastname: Cools
authors.affiliation: Department of Neonatology, University Hospital Gent, Gent, Belgium.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Zecic
authors.affiliation: Department of Neonatology, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Anton H
authors.initials: AH
authors.lastname: van Kaam
authors.affiliation: Department of Neonatology, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: t.r.dehaan@amc.uva.nl.
authors.forename: Timo R
authors.initials: TR
authors.lastname: de Haan
mesh_terms: D001238:Asphyxia Neonatorum / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D016015:Logistic Models; D008297:Male; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
keywords: Thompson encephalopathy score; clinical assessment tool; hypoxic-ischemic encephalopathy; neonatology; outcomes