Risk factors of death from severe neonatal respiratory distress syndrome

Abstract

Objective To explore the death risk factors of preterm infants with respiratory distress syndrome (RDS). Methods A retrospective analysis of 66 preterm infants with severe RDS, who admitted to our NICU between January 2010 and December 2011.The patients were divided into the death group and survival group according to the ending. Results There were a total of 24 cases died (36.36%). The death group′s mechanical ventilation time, the median of base excess, the minimum median of pH, PaO2/FiO2, average gestational age, average birth weight, 1 minute Apgar score and 5 minute Apgar score were all lower than those of survival group (P 60%, intrauterine distress, polyembryony, sore for neonatal acute physiology perinatal extension version Ⅱ(SNAPPE-Ⅱ) score were all higher than those of survival group (P 0.05). Further Logistic regression analysis showed that independent risk factors were birth weight, 1 minute Apgar score and SNAPPE-Ⅱ score, OR were 0.990, 0.141 and 1.240 respectively.Receiver operating characteristic analysis of the ability of SNAPPE-Ⅱ score predicting death risk showed the area under curve was 0.86, the difference was statistically significant compared with 0.5 (P=0.000). Death risk prediction showed that the demarcation point SNAPPE-Ⅱ score=24.50 corresponded to the maximum (Youden index=0.70) correct prediction effect. Conclusion Independent risk factors of died from severe RDS are birth weight, 1 minute Apgar score and SNAPPE-Ⅱ scores; SNAPPE-Ⅱ score predicts risk of death from severe RDS accuracy is medium, equal to 24.50 is the best accuracy to the death risk prediction. Key words: Neonatal respiratory distress syndrome; Death; Risk factors; Premature infants