PS-046 First Day Heart Rate Characteristics Predict Death And Adverse Events In Preterm Infants

PurposeAbnormal heart rate characteristics (HRC) of decreased variability and decelerations occur in preterm infants with sepsis and other pathologic conditions. We sought to determine whether an HRC index (HeRO score) in the first day after birth predicts death and morbidities and to compare it to...

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Bibliographic Details
Published inArchives of disease in childhood Vol. 99; no. Suppl 2; p. A128
Main Authors Fairchild, K, Sullivan, BA, McClure, C J, Hicks, J, Lake, DE, Moorman, J R
Format Journal Article
LanguageEnglish
Published London BMJ Publishing Group LTD 01.10.2014
Subjects
Body Weight
Death
Dysplasia
Enterocolitis
Gestational age
Heart rate
Hemorrhage
Infants
Intestine
Low birth weight
Morbidity
Mortality
Necrotizing enterocolitis
Neonates
Newborn babies
Periventricular leukomalacia
Premature babies
Premature Infants
Retinopathy
Sepsis
Septicemia
Ultrasound
Young Children
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Summary:PurposeAbnormal heart rate characteristics (HRC) of decreased variability and decelerations occur in preterm infants with sepsis and other pathologic conditions. We sought to determine whether an HRC index (HeRO score) in the first day after birth predicts death and morbidities and to compare it to an established risk index, the Score for Neonatal Acute Physiology (SNAP-II).MethodsThe HRC index was analysed within 24 h of birth in 163 extremely low birth weight infants, and SNAP-II was calculated when data were available. Associations between the maximum HRC index (HRC-1), SNAP-II, and death and major morbidities were analysed using logistic regression to correct for gestational age.ResultsHRC-1 was significantly associated with death, severe head ultrasound abnormalities (sHUS = grade 3–4 intraventricular haemorrhage or cystic periventricular leukomalacia), and late-onset septicemia (LOS) (Table). SNAP-II could be calculated in 122 cases (75%) and was correlated with HRC-1 (r = 0.50, p < 0.0001) and with death, sHUS, and bronchopulmonary dysplasia (BPD). Neither score predicted necrotizing enterocolitis or spontaneous intestinal perforation (NEC/SIP), or severe retinopathy of prematurity (ROP).ConclusionThe HRC index in the first day after birth predicts death and multiple morbidities in ELBW infants and is strongly correlated with SNAP-II, an established illness severity score.Abstract PS-046 Table 1Outcome% with OutcomeHRC-1 p = *SNAP p = *Death19%0.009<0.001Severe HUS19%0.0060.001Late-onset septicemia24%0.0490.714NEC/SIP13%0.5650.142BPD55%0.1860.018Severe ROP8%0.5550.204Survival, No Morbidities25%0.0290.010* corrected for gestational age
ISSN:0003-9888
1468-2044
DOI:10.1136/archdischild-2014-307384.343