Revalidation of the score for neonatal acute physiology in the Vermont Oxford Network

John A.F. Zupancic, Douglas K. Richardson, Jeffrey D. Horbar, Joseph H. Carpenter, Shoo K. Lee, Gabriel J. Escobar, Esmond Arrindell, David Corcoran, Douglas Dransfield, Keith Gallaher, Jeffrey Gerdes, Roger Hinson, David Hoffman, Patrick Lewallen, Allen Merritt, Jeanne Webb, Vijay Baichoo, Gregory Samson, Su Boynton, Pauline GrazianoJoaquim Pinheiro, Agnes Salvador, David Schutzman, Brenda Douglass, Kim Reese, Dianna Garner, Dan Sobel, Pam McKinley, Jonathan Whitfield, John Zupancic, Keith J. Gallaher, Anne Sheaves, Cyndi Atkinson, Philippe S. Friedlich, Tina Bair, Judy Ohlinger, Howard S. Cohen, Constance McConnell, Michael Friedman, Lloyd Tinianow, Kathy Leef, David Paul, Jack Lorenz, Kiyoko Ohira-Kist, Patty Lore, Rick McClead, Cynthia Dembofsky, Sonia Hulman, Ed Beaumont, Dinah Sutton, William MacKendrick, Sue Wolf, David Shutzman, Craig Anderson, Nancy Wagner, Raul F. Cifuentes, Mary Ann Tyler, Savitri Kumar, Bonnie Malmberg, Sture Andersson, Marita Suni, Judy Burke, Jeffrey Merrill, Bharti Razdan, Misrak Tadesse, Robin Baker, Rebecca Beck, Lauren Johnson-Robbins, Jagjit Teji, Rohitkumar Vasa, Arthur Strauss, Douglas Carbine, Robert McArtor, Jane Ranney, Daniele Merazzi, Ihor Bilyk, Soraya Abbasi, Wendy Boehm, Patricia Ittmann, Anthony Barone, Anantham Harin, Carolyn Herrington, Padmani Karna, Barbara Long, Arturo Santos, Maryanne Merritt, T. Allen Merritt, Maria Duenas, Brenda Bigley, Dennis Crouse, Jeffrey Garland, Susan Kannenberg, Michael Dunn, Allyson Nichols, Patrick LeBlanc, Meena LaCorte, Gerald D. Brown, David J. Hoffman, Francis J. Bednarek, Mary L. Naples, Nem Yun Boo, Ismail Juriza, Al Cain, Ronald Dechert, Barry Bloom, Paula Delmore, Roger M. Hinson

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVES. Our specific objectives were (1) to document the performance of the revised Score for Neonatal Acute Physiology and the revised Score for Neonatal Acute Physiology Perinatal Extension in predicting death in the Vermont Oxford Network, compared with published normative values; (2) to determine whether this performance could be improved through recalibration of the weights for individual score items; (3) to determine the impact of including congenital anomalies in the predictive model; and (4) to compare performance against that of the Vermont Oxford Network risk adjustment, separately and in combination. METHODS. Fifty-eight Vermont Oxford Network centers collected data prospectively for the revised Score for Neonatal Acute Physiology in the first 12 hours after admission of infants in 2002. RESULTS. Data were collected for 10 469 infants, and analyses were undertaken for 9897 who met inclusion criteria. The median revised Score for Neonatal Acute Physiology was 5, and the mean birth weight was 1951 g. Recalibration of the revised Score for Neonatal Acute Physiology and revised Score for Neonatal Acute Physiology Perinatal Extension resulted in minimal changes in their discriminatory abilities. The Vermont Oxford Network risk adjustment performed similarly, compared with the revised Score for Neonatal Acute Physiology Perinatal Extension. CONCLUSIONS. Current score performance was similar to that observed previously, which suggests that the revised Score for Neonatal Acute Physiology and revised Score for Neonatal Acute Physiology Perinatal Extension have not decalibrated over the 7 years since the first cohort was assembled, despite advances in neonatal care during that period. Addition of congenital anomalies to the revised Score for Neonatal Acute Physiology Perinatal Extension improved discrimination significantly, particularly for infants with birth weights of >1500 g. The Vermont Oxford Network risk adjustment performed similarly, compared with the revised Score for Neonatal Acute Physiology Perinatal Extension.

Original languageEnglish (US)
Pages (from-to)e156-e163
JournalPediatrics
Volume119
Issue number1
DOIs
StatePublished - Jan 2007

Keywords

  • Illness severity
  • Infant
  • Newborn
  • Predictive value of tests

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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