新生儿危重病例评分与新生儿急性生理学评分围产期补充Ⅱ的应用比较

A comparative analysis of neonatal critical illness score and score for neonatal acute physiology, perinatal extension, version II

摘要:

目的 探讨新生儿危重病例评分 （NCIS）与新生儿急性生理学评分围产期补充Ⅱ （SNAPPE-Ⅱ）两种评分系统预测危重新生儿死亡放弃风险的准确度及临床实用性。方法 269例危重新生儿根据病情转归分为死亡放弃组及好转治愈组，比较两种评分系统预测死亡放弃风险的准确度。结果 死亡放弃组患儿的SNAPPE-Ⅱ得分明显高于好转治愈组患儿，差异有统计学意义 （P < 0.001），两组患儿NCIS评分的差异无统计学意义 （P=0.091），而符合单项指标的患儿死亡放弃风险明显高于不符合单项指标患儿 （P=0.005）。结论 SNAPPE-Ⅱ在危重新生儿死亡放弃风险的早期预测中具有更高的准确性，NCIS中单项指标对预测病情转归有指导意义。

Abstract:

Objective To investigate the accuracy and clinical utility of neonatal critical illness score (NCIS) and score for neonatal acute physiology, perinatal extension, version II (SNAPPE-II) in predicting the "dead and abandoned" risk in critically ill neonates. Methods A total of 269 critically ill neonates were divided into two groups according to their prognosis:dead/abandoned and improved/cured. The accuracy of these two scoring systems, NCIS and SNAPPE-II, in predicting the "dead and abandoned" risk was compared. Results The dead/abandoned group had a significantly higher SNAPPE-II score than the improved/cured group (P < 0.001), while there was no significant difference in the NCIS score between the two groups (P=0.091). The children who were in line with the individual indicator in the NCIS results had a significantly higher "dead and abandoned" risk than those who were not (P=0.005). Conclusions SNAPPE-II is more accurate in early prediction of the "dead and abandoned" risk in critically ill neonates compared with NCIS. NCIS has the ability to predict the "dead and abandoned" risk in children in line with the individual indicator.