关键词: 转运新生儿, 7d内死亡, 重度脑室内出血, 机械通气, 病情评估

Abstract:

Abstract：Objective To evaluate the performance of the Transport Risk Index of Physiologic Stability（TRIPS），Score for Neonatal Acute Physiology，Version Ⅱ（SNAP-Ⅱ） and Score for Neonatal Acute Physiology-Perinatal Extension， Version Ⅱ（SNAPPE-Ⅱ） for severity of transported neonates. Methods The study enrolled the neonates transported to Department of Neonatology， Children’s Hospital of Chongqing Medical University from Jan.1 to Dec. 31 of 2012. The clinical data were collected and analyzed retrospectively to compare the prediction accuracy of 7-day mortality，severe （≥Grade Ⅲ） intra-ventricular hemorrhage（IVH） and mechanical ventilation（MV）. Results Totally 475 neonates were enrolled.Hosmer-Lemeshow goodness-of-fit test showed good calibration of the TRIPS（P = 0.73），SNAP-Ⅱ（P = 0.30） and SNAPPE-Ⅱ（P = 0.27），and the TRIPS was the best. TRIPS，SNAP-Ⅱand SNAPPE-Ⅱ discriminated 7-day mortality with receiver operating characteristic area（AUC） of 0.80，0.82 and 0.84，respectively，whereas the predictive performance for severe IVH was 0.70， 0.69 and 0.83，and the performance for MV 0.72，0.72 and 0.74，respectively. There was no significant difference among these three scoring systems（P＞0.05）. With the cut-off value of 20 points， the sensibility of TRIPS predicting 7-day mortality and MV was 89.1% and 72.5%，respectively，whereas the specificity 57.7% and 66.8%. Conclusion Compared with SNAP-Ⅱ，SNAPPE-Ⅱ and NCIS，TRIPS is more suitable for quick severity evaluation due to its simplicity and feasibility，especially in accurately predicting 7-day mortality，severe IVH and MV of transported neonates.

Key words: transported neonates；7-day mortality；severe intra-ventricular hemorrhage； mechanical ventilation, severity evaluation