PS-154 Has Therapeutic Hypothermia (th) Changed The Prognostic Value Of Clinical Evaluation Of Neonatal Hypoxic-ischaemic Encephalopathy (hie)? A Systematic Review And Meta-analysis

Abstract

Background Clinical grading of HIE correlates with outcome. TH improves survival and neurodevelopment in HIE. Aim: To review the effect of TH on the prognostic value of clinical grading of HIE and its course. Methods Systematic review and meta-analysis of studies on the ability of Sarnat stage at defined times to predict death/disability at ≥18 m in normothermia and TH-treated term neonates with HIE. Pooled risks were estimated, with random effect models, according to HIE stage and treatment. Results Data on encephalopathy stage at The proportion of infants with moderate encephalopathy at 2 = 48%) in normothermia-treated and 35% (95% CI:28–41; I 2 = 51%) in TH-treated neonates. The proportion for severe encephalopathy was 83% (95% CI:72–93; I 2 = 81%) in normothermia and 67% (95% CI:58–76; I 2 = 74%) in TH. At 2 = 35%) in normothermia and 3.77 (95% CI:2.62–5.41; I 2 = 0%) in TH. TH did not affect HIE grade at 72 h. No improvement of encephalopathy at 72 h increased the risk of poor outcome (OR 8.21, 95% CI:2.01–33.6; I 2 = 74%). The ORs for persistent moderate and severe encephalopathy at 72 h to predict unfavourable outcome were 5.09 (95% CI:1.53–16.92; I 2 = 66%) and 42.83 (95% CI:13.55–135.37; I 2 = 44%). Conclusions While TH has changed the predictive values of initial HIE grades, clinical staging at