Sutcuoglu Sumer, Celik Tugce, Alkan Senem, Ilhan Ozkan, Ozer Esra Arun
From the Tepecik Teaching and Research Hospital, Neonatal Intensive Care Unit, Izmir, Turkey.
Pediatr Emerg Care. 2015 Feb;31(2):113-6. doi: 10.1097/PEC.0000000000000350.
To predict the risk of mortality of neonates, birth weight and gestational age were previously used. However, these criteria were considered inadequate; therefore, various scoring systems have been developed in the recent years. The aim of the study was to evaluate the performance of predicting mortality by Mortality Index for Neonatal Transportation (MINT), Score for Neonatal Acute Physiology-Perinatal Extension II (SNAP-PE-II), and Transport Related Mortality Score (TREMS).
All infants transferred to the neonatal intensive care unit between January 1 and December 31, 2011, were included. The scores of SNAP-PE-II, MINT, and TREMS of the all cases were calculated. TREMS is our proposed scoring system and it consists of 5 variables (hypoglycemia, hypoxia, hypercarbia, hypotension, and hypothermia). The scoring systems, SNAP-PE-II, MINT, and TREMS, were compared in terms of mortality risk.
A total of 306 newborn infants constituted the study population. The mean gestational age was 33.1 ± 5 weeks and the mean birth weight was 2031.2 ± 1018 g, and 183 (59%) babies were male. The sensitivity of MINT score for predicting mortality was higher than SNAP-PE-II and TREMS. However, specificity was higher in TREMS score. The negative predictive value was highest in MINT score, whereas TREMS has the highest positive predictive value.
The TREMS scoring system is a simple scoring system with a high specificity for predicting mortality. Further studies with larger sample size including more centers and newborn infants with diverse clinical problems are needed to assess the validity and reliability of the TREMS scoring system.
以往曾采用出生体重和胎龄来预测新生儿的死亡风险。然而，这些标准被认为并不充分；因此，近年来已开发出各种评分系统。本研究的目的是评估新生儿转运死亡率指数（MINT）、新生儿急性生理学围产期扩展Ⅱ评分（SNAP-PE-II）和转运相关死亡率评分（TREMS）在预测死亡率方面的表现。
纳入2011年1月1日至12月31日期间转入新生儿重症监护病房的所有婴儿。计算所有病例的SNAP-PE-II、MINT和TREMS评分。TREMS是我们提出的评分系统，它由5个变量（低血糖、低氧血症、高碳酸血症、低血压和体温过低）组成。对SNAP-PE-II、MINT和TREMS这三种评分系统在死亡风险方面进行比较。
共有306例新生儿构成研究人群。平均胎龄为33.1±5周，平均出生体重为2031.2±1018g，183例（59%）婴儿为男性。MINT评分预测死亡率的敏感性高于SNAP-PE-II和TREMS。然而，TREMS评分的特异性更高。MINT评分的阴性预测值最高，而TREMS的阳性预测值最高。
TREMS评分系统是一种简单的评分系统，在预测死亡率方面具有较高的特异性。需要进行更大样本量、纳入更多中心以及患有各种临床问题的新生儿的进一步研究，以评估TREMS评分系统的有效性和可靠性。
