Ambalavanan et al developed scores for evaluating extremely premature infants. One score can help to identify an infant who is at increased risk for rehospitalization. The authors are from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, University of Alabama and RTI International (Research Triangle Park, North Carolina).
Patient selection: extremely premature infant with birthweight 787 +/- 136 grams and gestational age 26 +./- 2 weeks.
Outcome: readmission during follow-up (18 to 22 months)
Parameters:
(1) gender
(2) shunt for hydrocephalus
(3) duration of hospital stay for pulmonary reasons
(4) FIO2 at 36 weeks
(5) proven necrotizing enterocolitis or spontaneous GI tract perforation
Parameter
Finding
Points
gender
female
1
male
1.3
shunt for hydrocephalus
no
1
yes
4.5
hospitalized > 120 days for pulmonary reasons
no
1
yes
1.9
FIO2 at 36 weeks
0.21
1
0.22 to 0.28
1.3
> 0.28
1.6
necrotizing enterocolitis or spontaneous GI perforation
no
1
yes
1.6
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 5
• maximum score 10.9
• The higher the score the greater the chances of being readmitted.
Performance:
• The area under the ROC curve was 0.63.
• A score > 5.3 (anything more than a mild increase in FIO2 or male gender) was 75% sensitive and 40% specific.
• A score > 5.6 was 42% sensitive and 79% specific.
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