极低出生体重儿和早产儿死亡风险模型的比较：系统评价与荟萃分析
Comparing mortality risk models in VLBW and preterm infants: systematic review and meta-analysis.
作者信息
McLeod Jennifer S, Menon Anitha, Matusko Niki, Weiner Gary M, Gadepalli Samir K, Barks John, Mychaliska George B, Perrone Erin E
机构信息
Department of Surgery, Section of Pediatric Surgery, University of Michigan, Michigan Medicine, Ann Arbor, MI, 48109, USA.
University of Michigan Medical School, Ann Arbor, MI, 48109, USA.
出版信息
J Perinatol. 2020 May;40(5):695-703. doi: 10.1038/s41372-020-0650-0. Epub 2020 Mar 18.
OBJECTIVE
To compare the prognostic accuracy of six neonatal illness severity scores (CRIB, CRIB II, SNAP, SNAP II, SNAP-PE, and SNAP-PE II), birthweight (BW), and gestational age (GA) for predicting pre-discharge mortality among very low birth weight (VLBW) infants (<1500 g) and very preterm infants (<32 weeks' gestational age).
STUDY DESIGN
PubMed, EMBASE, and Scopus were the data sources searched for studies published before January 2019. Data were extracted, pooled, and analyzed using random-effects models and reported as AUC with 95% confidence intervals (CI).
RESULTS
Of 1659 screened studies, 24 met inclusion criteria. CRIB was the most discriminate for predicting pre-discharge mortality [AUC 0.88 (0.86-0.90)]. GA was the least discriminate [AUC 0.76 (0.72-0.80)].
CONCLUSIONS
Although the original CRIB score was the most accurate predictor of pre-discharge mortality, significant heterogeneity between studies lowers confidence in this pooled estimate. A more precise illness severity score to predict pre-discharge mortality is still needed.
目的
比较六种新生儿疾病严重程度评分（CRIB、CRIB II、SNAP、SNAP II、SNAP-PE和SNAP-PE II）、出生体重（BW）和胎龄（GA）对预测极低出生体重（VLBW）婴儿（<1500g）和极早产儿（<32周胎龄）出院前死亡率的预后准确性。
研究设计
检索了PubMed、EMBASE和Scopus这三个数据源，以获取2019年1月之前发表的研究。使用随机效应模型提取、汇总和分析数据，并报告为具有95%置信区间（CI）的AUC。
结果
在1659项筛查研究中，24项符合纳入标准。CRIB在预测出院前死亡率方面最具区分性【AUC 0.88（0.86-0.90）】。GA的区分性最小【AUC 0.76（0.72-0.80）】。
结论
尽管原始的CRIB评分是出院前死亡率最准确的预测指标，但研究之间存在显著异质性，降低了对这一汇总估计值的可信度。仍需要一个更精确的疾病严重程度评分来预测出院前死亡率。
Zotero 插件