Derivation and Validation of a Risk Score to Predict Mortality of Early Neonates at Neonatal Intensive Care Unit: The END in NICU Score

Yitayeh Belsti,1 Zelalem Mehari Nigussie,2 Gebeyaw Wudie Tsegaye2 1Department of Physiology, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia; 2Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Scie...

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Autores principales:	Belsti Y, Nigussie ZM, Tsegaye GW
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	derivation validation risk score early neonatal mortality nicu ethiopia Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/1e405c2168bd4c58afe1e0460013f693
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spelling	oai:doaj.org-article:1e405c2168bd4c58afe1e0460013f6932021-11-11T18:22:26ZDerivation and Validation of a Risk Score to Predict Mortality of Early Neonates at Neonatal Intensive Care Unit: The END in NICU Score1178-7074https://doaj.org/article/1e405c2168bd4c58afe1e0460013f6932021-11-01T00:00:00Zhttps://www.dovepress.com/derivation-and-validation-of-a-risk-score-to-predict-mortality-of-earl-peer-reviewed-fulltext-article-IJGMhttps://doaj.org/toc/1178-7074Yitayeh Belsti,1 Zelalem Mehari Nigussie,2 Gebeyaw Wudie Tsegaye2 1Department of Physiology, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia; 2Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, EthiopiaCorrespondence: Yitayeh BelstiDepartment of Physiology, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, EthiopiaEmail yitayehbelsti@gmail.comBackground: Early neonatal death is death of infants in the first week of life. And 34% to 92% of neonatal deaths happen within 7 days of postnatal period. Thus, the early neonatal period is the most critical time for an infant, requiring different strategies to prevent mortality. Among strategies, deriving and implementing early warning scores is crucial to predict early neonatal mortality earlier upon hospital admission.Objective: To derive and validate a risk score to predict mortality of early neonates at Felege Hiwot Specialized Hospital neonatal intensive care unit, Bahir Dar, 2021.Methods: The document review was conducted from February 24, to April 08, 2021, on all early neonates admitted to neonatal intensive care unit from January 1, 2018 to December 31, 2020. The total number of early neonates included in the derivation study was 1100. Data were collected by using checklists prepared on EpiCollect5 software. After exporting the data to R version 4.0.5 software, variables with (p < 0.25) from the simple binary regression were entered into a multiple logistic regression model, and significant variables (p < 0.05) were kept in the model. The discrimination and calibration were assessed. The model was internally validated using bootstrapping technique.Results: Admission weight, birth Apgar score, perinatal asphyxia, respiratory distress syndrome, mode of delivery, sepsis, and gestational age at birth remained in the final multiple logistic regression prediction model. The area under curve of receiver operating characteristic curve for early neonatal mortality score was 90.7%. The model retained excellent discrimination under internal validation. The sensitivity, specificity, and positive predictive value, negative predictive value of the model was 89.4%, 82.5%, 55.5%, and 96.9%, respectively.Conclusion: The derived score has an excellent discriminative ability and good prediction performance. This is an important tool for predicting early neonatal mortality in neonatal intensive care units at admission.Keywords: derivation, validation, risk score, early neonatal mortality, NICU, EthiopiaBelsti YNigussie ZMTsegaye GWDove Medical Pressarticlederivationvalidationrisk scoreearly neonatal mortalitynicuethiopiaMedicine (General)R5-920ENInternational Journal of General Medicine, Vol Volume 14, Pp 8121-8134 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	derivation validation risk score early neonatal mortality nicu ethiopia Medicine (General) R5-920
spellingShingle	derivation validation risk score early neonatal mortality nicu ethiopia Medicine (General) R5-920 Belsti Y Nigussie ZM Tsegaye GW Derivation and Validation of a Risk Score to Predict Mortality of Early Neonates at Neonatal Intensive Care Unit: The END in NICU Score
description	Yitayeh Belsti,1 Zelalem Mehari Nigussie,2 Gebeyaw Wudie Tsegaye2 1Department of Physiology, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia; 2Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, EthiopiaCorrespondence: Yitayeh BelstiDepartment of Physiology, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, EthiopiaEmail yitayehbelsti@gmail.comBackground: Early neonatal death is death of infants in the first week of life. And 34% to 92% of neonatal deaths happen within 7 days of postnatal period. Thus, the early neonatal period is the most critical time for an infant, requiring different strategies to prevent mortality. Among strategies, deriving and implementing early warning scores is crucial to predict early neonatal mortality earlier upon hospital admission.Objective: To derive and validate a risk score to predict mortality of early neonates at Felege Hiwot Specialized Hospital neonatal intensive care unit, Bahir Dar, 2021.Methods: The document review was conducted from February 24, to April 08, 2021, on all early neonates admitted to neonatal intensive care unit from January 1, 2018 to December 31, 2020. The total number of early neonates included in the derivation study was 1100. Data were collected by using checklists prepared on EpiCollect5 software. After exporting the data to R version 4.0.5 software, variables with (p < 0.25) from the simple binary regression were entered into a multiple logistic regression model, and significant variables (p < 0.05) were kept in the model. The discrimination and calibration were assessed. The model was internally validated using bootstrapping technique.Results: Admission weight, birth Apgar score, perinatal asphyxia, respiratory distress syndrome, mode of delivery, sepsis, and gestational age at birth remained in the final multiple logistic regression prediction model. The area under curve of receiver operating characteristic curve for early neonatal mortality score was 90.7%. The model retained excellent discrimination under internal validation. The sensitivity, specificity, and positive predictive value, negative predictive value of the model was 89.4%, 82.5%, 55.5%, and 96.9%, respectively.Conclusion: The derived score has an excellent discriminative ability and good prediction performance. This is an important tool for predicting early neonatal mortality in neonatal intensive care units at admission.Keywords: derivation, validation, risk score, early neonatal mortality, NICU, Ethiopia
format	article
author	Belsti Y Nigussie ZM Tsegaye GW
author_facet	Belsti Y Nigussie ZM Tsegaye GW
author_sort	Belsti Y
title	Derivation and Validation of a Risk Score to Predict Mortality of Early Neonates at Neonatal Intensive Care Unit: The END in NICU Score
title_short	Derivation and Validation of a Risk Score to Predict Mortality of Early Neonates at Neonatal Intensive Care Unit: The END in NICU Score
title_full	Derivation and Validation of a Risk Score to Predict Mortality of Early Neonates at Neonatal Intensive Care Unit: The END in NICU Score
title_fullStr	Derivation and Validation of a Risk Score to Predict Mortality of Early Neonates at Neonatal Intensive Care Unit: The END in NICU Score
title_full_unstemmed	Derivation and Validation of a Risk Score to Predict Mortality of Early Neonates at Neonatal Intensive Care Unit: The END in NICU Score
title_sort	derivation and validation of a risk score to predict mortality of early neonates at neonatal intensive care unit: the end in nicu score
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/1e405c2168bd4c58afe1e0460013f693
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Derivation and Validation of a Risk Score to Predict Mortality of Early Neonates at Neonatal Intensive Care Unit: The END in NICU Score

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