评估加利福尼亚州新生儿转运的质量。

Estimating the quality of neonatal transport in California.

机构信息

1] Department of Pediatrics, Division of Neonatal-Perinatal Medicine Stanford University School of Medicine, Stanford, CA, USA [2] California Perinatal Quality Care Collaborative, Palo Alto, CA, USA.

出版信息

J Perinatol. 2013 Dec;33(12):964-70. doi: 10.1038/jp.2013.57. Epub 2013 Sep 26.

DOI:10.1038/jp.2013.57

PMID:24071907

Abstract

OBJECTIVE

To develop a strategy to assess the quality of neonatal transport based on change in neonatal condition during transport.

STUDY DESIGN

The Canadian Transport Risk Index of Physiologic Stability (TRIPS) score was optimized for a California (Ca) population using data collected on 21 279 acute neonatal transports, 2007 to 2009, using models predicting (2/3) and validating (1/3) mortality within 7 days of transport. Quality Change Point 10th percentile (QCP10), a benchmark of the greatest deterioration seen in 10% of the transports by top-performing teams, was established.

RESULT

Compared with perinatal variables (0.79), the Ca-TRIPS had a validation receiver operator characteristic area for prediction of death of 0.88 in all infants and 0.86 in infants transported after day 7. The risk of death increased 2.4-fold in infants whose deterioration exceeded the QCP10.

CONCLUSION

We present a practical, benchmarked, risk-adjusted, estimate of the quality of neonatal transport.

摘要

目的

制定一种基于转运过程中新生儿病情变化来评估新生儿转运质量的策略。

研究设计

利用 2007 年至 2009 年间在加利福尼亚州收集的 21279 例急性新生儿转运数据，对加拿大转运生理稳定性风险指数（TRIPS）评分进行了优化，该评分用于预测（2/3）和验证（1/3）转运后 7 天内的死亡率。确定了质量变化临界点第 10 百分位数（QCP10），这是表现最佳的团队所看到的 10%转运中最大恶化的基准。