Rech Till, Rubarth Kerstin, Bührer Christoph, Balzer Felix, Dame Christof
Department of Neonatology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Berlin, Germany.
JMIR Pediatr Parent. 2024 Feb 28;7:e50575. doi: 10.2196/50575.
The severity of neonatal abstinence syndrome (NAS) may be assessed with the Finnegan score (FS). Since the FS is laborious and subjective, alternative ways of assessment may improve quality of care.
In this pilot study, we examined associations between the FS and routine monitoring data obtained from the electronic health record system.
The study included 205 neonates with NAS after intrauterine (n=23) or postnatal opioid exposure (n=182). Routine monitoring data were analyzed at 60±10 minutes (t-1) and 120±10 minutes (t-2) before each FS assessment. Within each time period, the mean for each variable was calculated. Readings were also normalized to individual baseline data for each patient and parameter. Mixed effects models were used to assess the effect of different variables.
Plots of vital parameters against the FS showed heavily scattered data. When controlling for several variables, the best-performing mixed effects model displayed significant effects of individual baseline-controlled mean heart rate (estimate 0.04, 95% CI 0.02-0.07) and arterial blood pressure (estimate 0.05, 95% CI 0.01-0.08) at t-1 with a goodness of fit (R2m) of 0.11.
Routine electronic data can be extracted and analyzed for their correlation with FS data. Mixed effects models show small but significant effects after normalizing vital parameters to individual baselines.
新生儿戒断综合征（NAS）的严重程度可用芬尼根评分（FS）进行评估。由于FS评估繁琐且主观，其他评估方法可能会改善护理质量。
在这项初步研究中，我们检验了FS与从电子健康记录系统获得的常规监测数据之间的关联。
该研究纳入了205例宫内（n = 23）或出生后暴露于阿片类药物（n = 182）的NAS新生儿。在每次FS评估前60±10分钟（t-1）和120±10分钟（t-2）分析常规监测数据。在每个时间段内，计算每个变量的平均值。读数也根据每个患者和参数的个体基线数据进行了标准化。使用混合效应模型评估不同变量的影响。
将生命参数与FS作图显示数据高度分散。在控制了几个变量后，表现最佳的混合效应模型显示，在t-1时，个体基线控制的平均心率（估计值0.04，95%CI 0.02 - 0.07）和动脉血压（估计值0.05，95%CI 0.01 - 0.08）有显著影响，拟合优度（R2m）为0.11。
可以提取和分析常规电子数据以研究其与FS数据的相关性。将生命参数标准化为个体基线后，混合效应模型显示出虽小但显著的影响。
