Portal de investigación
Neonatal assessment in the delivery room - Trial to Evaluate a Specified Type of Apgar (TEST-Apgar)
Fecha de publicación:
Autores de IIS La Fe
Participantes ajenos a IIS La Fe
- Rüdiger M
- Braun N
- Aranda J
- Bergert R
- Bystricka A
- Dimitriou G
- El-Atawi K
- Ifflaender S
- Jung P
- Matasova K
- Ojinaga V
- Petruskeviciene Z
- Roll C
- Schwindt J
- Simma B
- Staal N
- Valencia G
- Vasconcellos MG
- Veinla M
- Weber B
- Wendt A
- Yigit S
- Zotter H
- Küster H
- TEST-Apgar Study-Group
Grupos
Abstract
Background: Since an objective description is essential to determine infant's postnatal condition and efficacy of interventions, two scores were suggested in the past but weren't tested yet: The Specified-Apgar uses the 5 items of the conventional Apgar score; however describes the condition regardless of gestational age (GA) or resuscitative interventions. The Expanded-Apgar measures interventions needed to achieve this condition. We hypothesized that the combination of both (Combined-Apgar) describes postnatal condition of preterm infants better than either of the scores alone. Methods: Scores were assessed in preterm infants below 32 completed weeks of gestation. Data were prospectively collected in 20 NICU in 12 countries. Prediction of poor outcome ( death, severe/moderate BPD, IVH, CPL and ROP) was used as a surrogate parameter to compare the scores. To compare predictive value the AUC for the ROC was calculated. Results: Of 2150 eligible newborns, data on 1855 infants with a mean GA of 28(6/7) +/- 2(3/7) weeks were analyzed. At 1 minute, the Combined-Apgar was significantly better in predicting poor outcome than the Specified- or Expanded-Apgar alone. Of infants with a very low score at 5 or 10 minutes 81% or 100% had a poor outcome, respectively. In these infants the relative risk (RR) for perinatal mortality was 24.93 (13.16-47.20) and 31.34 (15.91-61.71), respectively. Conclusion: The Combined-Apgar allows a more appropriate description of infant's condition under conditions of modern neonatal care. It should be used as a tool for better comparison of group of infants and postnatal interventions.
Datos de la publicación
- ISSN/ISSNe:
- 1471-2431, 1471-2431
- Tipo:
- Article
- Páginas:
- 18-18
- PubMed:
- 25884954
- Factor de Impacto:
- 1,163 SCImago ℠
- Cuartil:
- Q1 SCImago ℠
BMC Pediatrics BMC
Citas Recibidas en Web of Science: 48
Documentos
- No hay documentos
Filiaciones
Keywords
- Apgar score; Expanded-Apgar; Specified-Apgar; Postnatal condition; Neonatal assessment; Delivery room management; Preterm resuscitation