Ekert et al identified risk factors associated with poor outcome associated with postasphyxial hypoxic-ischemic encephalopathy. These factors can be identified within 4 hours of birth. The authors are from the Hospital for Sick Children, Princess Margaret Hospital and the University of Toronto in Ontario, Canada.
NOTE: This model appears to have preceded the one reported in the previous section.
Severe adverse outcomes:
(1) cortical blindness
(2) deafness
(3) cerebral palsy
(4) developmental delay
Parameters:
(1) chest compressions
(2) time between delivery and spontaneous breathing
(3) seizures
Parameter
Finding
Points
chest compression
not administered
0
administered
1
time to breathing onset
< 10 minutes
0
>= 10 minutes
1
seizures
none or after 4 hours
0
onset <= 4 hours after birth
1
total number of risk factors =
= SUM(points for all 3 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 3
• The more risk factors present the more likely that the neonate will have a severe adverse outcome.
• A multivariate model was developed with coefficients listed in Appendix 2.
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