Department of Pediatrics, Navodaya Medical College, Raichur, Karnataka, India.
Department of Pediatrics, Indira Gandhi Medical College and Research Institute, Puducherry, India.
Indian J Pediatr. 2023 Apr;90(4):341-347. doi: 10.1007/s12098-022-04199-9. Epub 2022 Jul 4.
To devise a score based on eight extended sick neonatal score (ESNS) variables by adding two more variables, birth weight, and gestational age to check its efficacy.
A retrospective study was conducted on 521 neonates admitted from January 2018 to June 2020 in the neonatal intensive care unit (NICU) of a tertiary care center. The proposed score has the following components, respiratory effort, heart rate, axillary temperature, capillary refill time, random blood sugar, pulse oximeter saturation, Moro reflex, modified Downes score, gestation age, and birth weight. Each was scored as 0, 1, and 2. The total score for each neonate was calculated from the records available and outcome documented. Receiver operating characteristic (ROC) curve was generated; and a cutoff score was derived to predict mortality and compared with modified sick neonatal score (MSNS).
Modified ESNS has a strong correlation with the outcome. Area under the ROC curve was 0.995 (95% CI: 0.925-0.985) for modified ESNS and 0.933 (95% CI: 0.901-0.976) for MSNS. The optimum cutoff values for predicting mortality were 15.5 for modified ESNS and 12.5 for MSNS. For a cutoff score of ≤ 15, sensitivity and specificity were 86.27% and 86.60% for modified ESNS and 90.20% and 84.89%, respectively, for MSNS, in predicting mortality. Positive and negative predictive values were 41.12% and 98.31% for modified ESNS and 39.32% and 98.76%, respectively for MSNS.
The modified ESNS can predict in-hospital mortality among neonates, with good sensitivity and specificity.
通过添加两个变量（出生体重和胎龄），基于八个扩展新生儿严重度评分（ESNS）变量制定一个评分，以检查其疗效。
对 2018 年 1 月至 2020 年 6 月在三级护理中心新生儿重症监护病房（NICU）住院的 521 例新生儿进行回顾性研究。提出的评分包括以下成分：呼吸努力、心率、腋温、毛细血管再充盈时间、随机血糖、脉搏血氧饱和度、Moro 反射、改良 Downs 评分、胎龄和出生体重。每个变量的评分分别为 0、1 和 2。根据可用记录和记录的结果计算每个新生儿的总分。生成受试者工作特征（ROC）曲线，并得出预测死亡率的截断分数，并与改良新生儿严重度评分（MSNS）进行比较。
改良 ESNS 与结局有很强的相关性。ROC 曲线下面积为 0.995（95%CI：0.925-0.985），用于改良 ESNS；0.933（95%CI：0.901-0.976），用于 MSNS。预测死亡率的最佳截断值为改良 ESNS 为 15.5，MSNS 为 12.5。对于截断评分≤15，改良 ESNS 预测死亡率的敏感度和特异性分别为 86.27%和 86.60%，MSNS 分别为 90.20%和 84.89%。改良 ESNS 的阳性和阴性预测值分别为 41.12%和 98.31%，MSNS 分别为 39.32%和 98.76%。
改良 ESNS 可预测新生儿院内死亡率，具有良好的敏感度和特异性。
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