Variations of Apgar score of very low birth weight infants in different neonatal intensive care units
Variations of Apgar score of very low birth weight infants in different neonatal intensive care units
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DOI：
10.1111/j.1651-2227.2009.01347.x
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发表时间：
2009-09-01
期刊：
影响因子：
3.8
通讯作者：
Tschirch, Edda
中科院分区：
文献类型：
--
作者：
Ruediger, Mario;Kuester, Helmut;Tschirch, Edda
目的：新生儿Apgar评分是一种客观评价新生儿状态的方法，但由于不同观察者之间差异较大，影响了其在早产儿中的应用。该研究测试了医生是否给予书面病例描述低分也适用于早产儿。患者和方法：描述（BMJ 2004; 329：143-4）被送往14个新生儿单位。要求医生评估Apgar评分（病例评分）。从2004年1月至2006年12月出生的所有极低出生体重儿（VLBW）的7个单位Apgar评分从图表（临床评分）中获得。结果：总共有121名医生从14个机构（中位数9，范围3-15）回答：24名居民6< 6-month and 28 with >个月的新生儿经验，69名顾问。病例评分的评估非常不均匀，呼吸、肌张力和反射变化很大。临床评分从1000 VLBW婴儿。评分取决于胎龄，24周时的中位数为4，27周时为7。有一个例外，中心分配低的情况下，分数也低的临床scores.Conclusion：有相当大的变化，在分配Apgar评分。需要定义将Apgar评分应用于临床条件下的婴儿，如早产，复苏或人工通气。
Objective:The Apgar score should be an objective method to assess the state of newborns; however, its applicability in preterm infants is hampered by large variations among different observers. The study tested whether physicians that give low scores to written case descriptions also apply lower scores to preterm infants.Patients and Methods:Descriptions (BMJ 2004; 329: 143-4) were sent to 14 neonatal units. Physicians were asked to evaluate the Apgar (case score). From seven units Apgar scores of all very low birth weight infants (VLBW) born between January 2004 and December 2006 were obtained from charts (clinical score).Results:In total, 121 physicians from 14 institutions (median 9, range 3-15) replied: 24 residents with < 6-month and 28 with > 6-month neonatal experience, and 69 consultants. The assessment of the case scores was very heterogeneous with large variations in respiration, muscle tone and reflexes. Clinical scores were obtained from 1000 VLBW infants. The score depended on the gestational age, with a median of 4 at 24 and 7 at 27 weeks. With one exception, centres that assigned low case scores had also low clinical scores.Conclusion:There is considerable variation in assigning Apgar scores. Definitions are required to apply the Apgar score to infants under clinical conditions such as preterm delivery, resuscitation or artificial ventilation.