Abstract
OBJECTIVE:
To develop and validate a model for very low birth weight (VLBW) neonatal mortality prediction, based on commonly available data at birth, in 16 neonatal intensive care units (NICUs) from five South American countries.
STUDY DESIGN:
Prospectively collected biodemographic data from the Neonatal del Cono Sur (NEOCOSUR) Network between October 2000 and May 2003 in infants with birth weight 500 to 1500?g were employed. A testing sample and crossvalidation techniques were used to validate a statistical model for risk of in-hospital mortality. The new risk score was compared with two existing scores by using area under the receiver operating characteristic curve (AUC).
RESULTS:
The new NEOCOSUR score was highly predictive for in-hospital mortality (AUC=0.85) and performed better than the Clinical Risk Index for Babies (CRIB) and the NICHD risk models when used in the NEOCOSUR Network. The new score is also well calibrated — it had good predictive capability for in-hospital mortality at all levels of risk (HL test=11.9, p=0.85). The new score also performed well when used to predict in hospital neurological and respiratory complications.
CONCLUSIONS:
A new and relatively simple VLBW mortality risk score had a good prediction performance in a South American network population. This is an important tool for comparison purposes among NICUs. This score may prove to be a better model for application in developing countries.
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Acknowledgements
We thank Linda Wright, MD and Abik Das, PhD for their useful suggestions and help in preparing this manuscript.
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Authors and Affiliations
Consortia
Appendix A1
Appendix A1
Participants Centers and Local Coordinators Grupo Colaborativo Neocosur in this study:
Argentina
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Clínica y Maternidad Suizo Argentina, Buenos Aires: Gabriel Musante, Luis Prudent, Marcio Alazrraqui.
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Hospital de Clínicas Jose de San Martín, Buenos Aires: Isabel Kurlat, Adriana Azcarate, Oscar Di Siervi.
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Hospital Italiano, Buenos Aires: Gonzalo Mariani, Jose María Ceriani, Silvia Fernandez.
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Hospital Juan Fernández, Buenos Aires: Liliana Roldan, Ileana Seguel, Hector Sexer.
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Hospital Lagomaggiore, Mendoza: Claudia Barros, Daniel Agost, Gabriela Torres, Augusto Fischetti, Jorge Ríos.
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Maternidad Sarda, Buenos Aires: Carlos Grandi, Monica Brundi, Nora Balanian, Claudio Solana, Miguel Larguia.
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Sanatorio de la Trinidad, Buenos Aires: Marcelo Decaro, Nestor Vain.
Chile
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Hospital Clinico Universidad Católica de Chile, Santiago: Jorge Fabres, Alberto Estay, Jose L Tapia, Alvaro Gonzalez.
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Hospital Clinico Universidad de Chile, Santiago: María Eugenia Hübner, Rodrigo Ramírez, Jaime Burgos.
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Hospital Guillermo Grant, ConcepciOn: Aldo Bancalari, Paulina Bello, Rodrigo Bustos, Lilian Cifuentes, Juan Fasce.
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Hospital Gustavo Fricke, Viña del Mar: Jane Standen, Marisol Escobar, Antonio Salvado, Alejandra Nuñez.
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Hospital San Jose, Santiago: Agustina González, Ana Luisa Candia, Lorena Tapia.
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Hospital Dr. Sotero del Rio, Santiago: Angélica Alegría, Enrica Pittaluga, Patricia Mena.
Paraguay
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Hospital de Clínicas de Asuncion: Jose Lacarruba, Ramón Mir.
Perú
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Hospital Cayetano Heredia, Lima: Enrique Bambaren, Veronica Webb, Marilu Rospigliosi, Jaime Zegarra.
Uruguay
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Facultad de Medicina Servicio de Recien Nacidos, Montevideo: Ruben Panizza, Sandra Gugliucci, Silvia Fernández, Ana Santos, Eduardo Mayans.
DataBase Unit Members
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Sandra Vignes, Ivonne D'Apremont, Jose L Tapia, Hernan Gonzalez, Guillermo Marshall, Alessandra Gederlini, Cristian Vilches, Macarena Icaza, Renato Venegas.
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Marshall, G., Tapia, J., D'Apremont, I. et al. A New Score for Predicting Neonatal Very Low Birth Weight Mortality Risk in the NEOCOSUR South American Network. J Perinatol 25, 577–582 (2005). https://doi.org/10.1038/sj.jp.7211362
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DOI: https://doi.org/10.1038/sj.jp.7211362
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