Qu Yangming, Huang Shuhan, Fu Xin, Wang Youping, Wu Hui
Department of Neonatology, The First Hospital of Jilin University, Changchun, China.
Front Neurol. 2020 Nov 24;11:592254. doi: 10.3389/fneur.2020.592254. eCollection 2020.
This work aimed to develop a predictive model of neonatal acute bilirubin encephalopathy. We retrospectively analyzed the data on extreme hyperbilirubinemia (EHB) newborns hospitalized in the First Hospital of Jilin University from January 1, 2012 to December 31, 2019. The demographic characteristics, pathological information, and admission examination results of newborns were collected to analyze the factors affecting acute bilirubin encephalopathy and to establish a predictive model. A total of 517 newborns were included in this study, of which 102 (19.7%) had acute bilirubin encephalopathy. T1WI hyperintensity [18.819 (8.838-40.069)], mother's age > 35 years [2.618 (1.096-6.2530)], abnormal white blood cell (WBC) [6.503 (0.226-18.994)], TSB level [1.340 (1.242-1.445)], and albumin level [0.812 (0.726-0.907)] were independently associated with neonatal acute bilirubin encephalopathy (ABE). All independently associated risk factors were used to form an ABE risk estimation nomogram. The bootstrap validation method was used to internally validate the resulting model. The nomogram demonstrated good accuracy in predicting the risk of ABE, with an unadjusted C index of 0.943 (95% CI, 0.919-0.962) and a bootstrap-corrected C index of 0.900. A nomogram was constructed using five risk factors of ABE. This model can help clinicians determine the best treatment for neonatal hyperbilirubinemia.
本研究旨在建立新生儿急性胆红素脑病的预测模型。我们回顾性分析了2012年1月1日至2019年12月31日在吉林大学第一医院住院的极重度高胆红素血症（EHB）新生儿的数据。收集新生儿的人口统计学特征、病理信息及入院检查结果，以分析影响急性胆红素脑病的因素并建立预测模型。本研究共纳入517例新生儿，其中102例（19.7%）发生急性胆红素脑病。T1WI高信号[18.819（8.838 - 40.069）]、母亲年龄>35岁[2.618（1.096 - 6.2530）]、白细胞（WBC）异常[6.503（0.226 - 18.994）]、总胆红素（TSB）水平[1.340（1.242 - 1.445）]及白蛋白水平[0.812（0.726 - 0.907）]与新生儿急性胆红素脑病（ABE）独立相关。所有独立相关的危险因素用于构建ABE风险估计列线图。采用自抽样验证方法对所得模型进行内部验证。该列线图在预测ABE风险方面显示出良好的准确性，未校正的C指数为0.943（95%CI，0.919 - 0.962），自抽样校正后的C指数为0.900。利用ABE的五个危险因素构建了列线图。该模型可帮助临床医生确定新生儿高胆红素血症的最佳治疗方案。
