Prediction of Mortality in Very Premature Infants A Systematic Review of Prediction Models 英文参考文献.docVIP

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Prediction of Mortality in Very Premature Infants A Systematic Review of Prediction Models 英文参考文献.doc

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Prediction of Mortality in Very Premature Infants A Systematic Review of Prediction Models 英文参考文献

PredictionofMortalityinVeryPrematureInfants:A SystematicReviewofPredictionModels StephanieMedlock1*,AnitaC.J.Ravelli1,PieterTamminga2,BenW.M.Mol3,AmeenAbu-Hanna1 1DepartmentofMedicalInformatics,AcademicMedicalCenter,UniversityofAmsterdam,Amsterdam,TheNetherlands,2DepartmentofNeonatology,AcademicMedical Center, University of Amsterdam, Amsterdam, The Netherlands, 3Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam,TheNetherlands Abstract Context:Beingbornverypretermisassociatedwithelevatedriskforneonatalmortality.Theaimofthisreviewistogivean overview of prediction models for mortality in very premature infants, assess their quality, identify important predictor variables,andproviderecommendationsfordevelopmentoffuturemodels. Methods:Studieswereincludedwhichreportedthepredictiveperformanceofamodelformortalityinaverypretermor verylowbirthweightpopulation,andclassifiedasdevelopment,validation,orimpactstudies.Foreachdevelopmentstudy, werecordedthepopulation,variables,aim,predictiveperformanceofthemodel,andthenumberoftimeseachmodelhad been validated. Reporting quality criteria and minimum methodological criteria were established and assessed for developmentstudies. Results:Weidentified41developmentstudiesand18validationstudies.Inadditiontogestationalageandbirthweight,eight variablesfrequentlypredictedsurvival:beingofaveragesizeforgestationalage,femalegender,non-whiteethnicity,absenceof seriouscongenitalmalformations,useofantenatalsteroids,higher5-minuteApgarscore,normaltemperatureonadmission,and betterrespiratorystatus.Twelvestudiesmetourmethodologicalcriteria,threeofwhichhavebeenexternallyvalidated.Low reportingscoreswereseeninreportingofperformancemeasures,internalandexternalvalidation,andhandlingofmissingdata. Conclusions:Multivariatemodelscanpredictmortalitybetterthanbirthweightorgestationalagealoneinverypreterm infants.Therearevalidatedpredictionmodelsforclassificationandcase-mixadjustment.Additionalresearchisneeded