Background: Since an objective description is essential to determine infant’s postnatal condition and efficacy of interventions, two scores were suggested in the past but weren’t tested yet: The Specified-Apgar uses the 5 items of the conventional Apgar score; however describes the condition regardless of gestational age (GA) or resuscitative interventions. The Expanded-Apgar measures interventions needed to achieve this condition. We hypothesized that the combination of both (Combined-Apgar) describes postnatal condition of preterm infants better than either of the scores alone.
Methods: Scores were assessed in preterm infants below 32 completed weeks of gestation. Data were prospectively collected in 20 NICU in 12 countries. Prediction of poor outcome (death, severe/moderate BPD, IVH, CPL and ROP) was used as a surrogate parameter to compare the scores. To compare predictive value the AUC for the ROC was calculated.
Results: Of 2150 eligible newborns, data on 1855 infants with a mean GA of 286/7± 23/7 weeks were analyzed. At 1 minute, the Combined-Apgar was significantly better in predicting poor outcome than the Specified- or Expanded-Apgar alone. Of infants with a very low score at 5 or 10 minutes 81% or 100% had a poor outcome, respectively. In these infants the relative risk (RR) for perinatal mortality was 24.93 (13.16-47.20) and 31.34 (15.91-61.71), respectively.
Conclusion: The Combined-Apgar allows a more appropriate description of infant’s condition under conditions of modern neonatal care. It should be used as a tool for better comparison of group of infants and postnatal interventions.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:28811 |
| Date | 23 July 2015 |
| Creators | Rüdiger, Mario, Braun, Nicole, Aranda, Jacob, Aguar, Marta, Bergert, Renate, Bystricka, Alica, Dimitriou, Gabriel, El-Atawi, Khaled, Ifflaender, Sascha, Jung, Philipp, Matasova, Katarina, Ojinaga, Violeta, Petruskeviciene, Zita, Roll, Claudia, Schwindt, Jens, Simma, Burkhard, Staal, Nanette, Valencia, Gloria, Vasconcellos, Maria Gabriela, Veinla, Maie, Vento, Máximo, Weber, Benedikt, Wendt, Anke, Yigit, Sule, Zotter, Heinz, Küster, Helmut |
| Contributors | TEST-Apgar study-group |
| Publisher | BioMed Central |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 10.1186/s12887-015-0334-7 |
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