TY - JOUR
T1 - Simplified Age-Weight Mortality Risk Classification for Very Low Birth Weight Infants in Low-Resource Settings
AU - Rosenberg, Rebecca E.
AU - Ahmed, Saifuddin
AU - Saha, Samir K.
AU - Ahmed, A. S.M.Nawshad U.
AU - Chowdhury, M. A.K.Azad
AU - Law, Paul A.
AU - Choi, Yoonjoung
AU - Mullany, Luke C.
AU - Tielsch, James M.
AU - Katz, Joanne
AU - Black, Robert E.
AU - Santosham, Mathuram
AU - Darmstadt, Gary L.
N1 - Funding Information:
The parent studies that provided support to the collection of data used for this analysis were funded by the Thrasher Research Fund (Dhaka); the Office of Health, Infectious Diseases and Nutrition, Global Health Bureau, United States Agency for International Development (USAID) [award HRN-A-00-96-90006-00 (Dhaka); awards HRN-A-00-97-00015-00 and GHS-A-00-03-000019-00 (Nepal); the Healthy Mother Healthy Child Results Package grant to John Snow, Inc., Cairo, Egypt (Cairo); and the Johns Hopkins Family Health and Child Survival Cooperative Agreement (Dhaka)]; Save the Children-US through a grant from the Bill and Melinda Gates Foundation (Dhaka); the Society for Pediatric Dermatology (Dhaka); the National Institutes of Health, National Institute of Child Health and Human Development (awards HD44004 and HD38753) (Nepal); and the Bill & Melinda Gates Foundation (award 810-2054) (Nepal).
PY - 2008/10
Y1 - 2008/10
N2 - Objective: To identify a valid neonatal mortality risk prediction score feasible for use in developing countries. Study design: Retrospective study of 467 neonates, ≤1500 g, enrolled in trials during 1998 to 2005 at tertiary care children's hospitals in Dhaka, Bangladesh, and Cairo, Egypt, and a community field site in Sarlahi District, Nepal. We derived simplified mortality risk scores and compared their predictive accuracy with the modified Clinical Risk Index for Babies (CRIB) II. Outcome was death during hospital stay (Dhaka and Cairo) or end of the neonatal period (Nepal). Results: The area under the curve receiver operating characteristic was 0.62, 0.71, 0.68, and 0.69 on the basis of the (a) CRIB II applied to the Dhaka-Cairo dataset; (b) an 18-category, simplified age, weight, sex score; (c) a binary-risk simplified age-weight (SAW) classification derived from the Dhaka-Cairo dataset; and (d) external validation of the binary-risk SAW classification in the Nepal dataset, respectively. Mortality risk prediction with the SAW classification on the basis of gestational age (≤29 weeks) or weight (<1000 g) was improved (P = .048) compared with CRIB II. Conclusions: The SAW classification is a markedly simplified mortality risk prediction score for use in identifying high-risk, very low birth weight neonates in developing country settings for whom urgent referral is indicated.
AB - Objective: To identify a valid neonatal mortality risk prediction score feasible for use in developing countries. Study design: Retrospective study of 467 neonates, ≤1500 g, enrolled in trials during 1998 to 2005 at tertiary care children's hospitals in Dhaka, Bangladesh, and Cairo, Egypt, and a community field site in Sarlahi District, Nepal. We derived simplified mortality risk scores and compared their predictive accuracy with the modified Clinical Risk Index for Babies (CRIB) II. Outcome was death during hospital stay (Dhaka and Cairo) or end of the neonatal period (Nepal). Results: The area under the curve receiver operating characteristic was 0.62, 0.71, 0.68, and 0.69 on the basis of the (a) CRIB II applied to the Dhaka-Cairo dataset; (b) an 18-category, simplified age, weight, sex score; (c) a binary-risk simplified age-weight (SAW) classification derived from the Dhaka-Cairo dataset; and (d) external validation of the binary-risk SAW classification in the Nepal dataset, respectively. Mortality risk prediction with the SAW classification on the basis of gestational age (≤29 weeks) or weight (<1000 g) was improved (P = .048) compared with CRIB II. Conclusions: The SAW classification is a markedly simplified mortality risk prediction score for use in identifying high-risk, very low birth weight neonates in developing country settings for whom urgent referral is indicated.
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U2 - 10.1016/j.jpeds.2008.04.051
DO - 10.1016/j.jpeds.2008.04.051
M3 - Article
C2 - 18539298
AN - SCOPUS:51649131142
SN - 0022-3476
VL - 153
SP - 519-524.e3
JO - Journal of Pediatrics
JF - Journal of Pediatrics
IS - 4
ER -