在资源丰富的环境中使用简化的唐斯评分来预测表面活性剂的使用情况。
Using a simplified Downes score to predict the receipt of surfactant in a highly resourced setting.
作者信息
Chotas William, Edwards Erika M, Horn Delia, Soll Roger, Ehret Danielle E Y
机构信息
Department of Pediatrics, University of Vermont Larner College of Medicine, Burlington, VT, USA.
Vermont Oxford Network, Burlington, VT, USA.
出版信息
J Perinatol. 2025 Jan;45(1):30-35. doi: 10.1038/s41372-024-02086-z. Epub 2024 Aug 5.
OBJECTIVE
The Downes score is a neonatal examination scoring tool frequently used to guide initiation of CPAP, but its ability to predict the need for surfactant has not been assessed. We assessed the extent to which the Downes score predicts the receipt of surfactant.
STUDY DESIGN
We calculated a simplified Downes score from nursing admission data for infants (≤ 2000 grams, and ≥ 25 weeks' gestation) admitted on CPAP to a highly resourced level III NICU, to assess the predictive value for the receipt of surfactant.
RESULTS
Fifty-three (31.5%) out of 168 infants admitted on CPAP received surfactant. A simplified Downes score of ≥ 4 predicted the receipt of surfactant with 90.6% sensitivity, 52.2% specificity, 46.6% positive predictive value, 92.3% negative predictive value, and 64.3% accuracy.
CONCLUSION
The high sensitivity and negative predictive value suggest utility for using the Downes score to help guide clinical decision making regarding surfactant therapy.
目的
唐斯评分是一种常用于指导持续气道正压通气（CPAP）启动的新生儿检查评分工具，但尚未评估其预测表面活性剂需求的能力。我们评估了唐斯评分预测表面活性剂使用情况的程度。
研究设计
我们根据入住配备资源丰富的三级新生儿重症监护病房（NICU）并接受CPAP治疗的婴儿（≤2000克，孕龄≥25周）的护理入院数据计算了简化的唐斯评分，以评估其对表面活性剂使用的预测价值。
结果
168名接受CPAP治疗的婴儿中有53名（31.5%）使用了表面活性剂。简化唐斯评分≥4预测表面活性剂使用的灵敏度为90.6%，特异度为52.2%，阳性预测值为46.6%，阴性预测值为92.3%，准确率为64.3%。
结论
高灵敏度和阴性预测值表明，唐斯评分有助于指导关于表面活性剂治疗的临床决策。
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