The Thompson Encephalopathy Score and Short-Term Outcomes in Asphyxiated Newborns Treated With Therapeutic Hypothermia

Autor: Jeroen Dudink, Alexandra Zecic, Arno van Heijst, Wes Onland, Jeroen R. Vermeulen, Patricia Thorsen, Monique Rijken, Henrika L.M. van Straaten, Martine C. Jansen-van der Weide, Timo R. de Haan, Anton H. van Kaam, Peter H. Dijk, Floris Groenendaal, Filip Cools, Inge A. Zonnenberg, Koen P. Dijkman
Přispěvatelé: Faculty of Medicine and Pharmacy, Clinical sciences, Growth and Development, Neonatology, MUMC+: MA Med Staf Spec Neurologie (9), Klinische Neurowetenschappen, RS: FHML non-thematic output, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, Pediatric surgery, ICaR - Ischemia and repair, Pediatrics
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Male
Pediatrics
medicine.medical_specialty
Time Factors
Encephalopathy
outcomes
Severity of Illness Index
neonatology
Hypoxic Ischemic Encephalopathy
Thompson encephalopathy score
03 medical and health sciences
0302 clinical medicine
Developmental Neuroscience
Interquartile range
Hypothermia
Induced
030225 pediatrics
Intensive care
Intensive Care Units
Neonatal
medicine
Journal Article
Humans
030212 general & internal medicine
hypoxic-ischemic encephalopathy
AMPLITUDE-INTEGRATED ELECTROENCEPHALOGRAM
clinical assessment tool
Asphyxia Neonatorum
PERINATAL ASPHYXIA
business.industry
Infant
Newborn
Gestational age
Odds ratio
medicine.disease
Perinatal asphyxia
Logistic Models
Treatment Outcome
Neurology
Anesthesia
Pediatrics
Perinatology and Child Health
Female
Neurology (clinical)
business
Cohort study
Zdroj: Pediatric neurology, 60, 49-53. Elsevier Inc.
Pediatric neurology, 60, 49-53. ELSEVIER SCIENCE INC
Pediatric Neurology, 60, 49-53. Elsevier Inc.
Pediatric Neurology, 60, 49-53
Pediatric Neurology, 60, 49. Elsevier Inc.
Thorsen, P, Jansen-van der Weide, M C, Groenendaal, F, Onland, W, van Straaten, H L M, Zonnenberg, I, Vermeulen, J R, Dijk, P H, Dudink, J, Rijken, M, van Heijst, A F, Dijkman, K P, Cools, F, Zecic, A, van Kaam, A H & Haan, T R 2016, ' The Thompson Encephalopathy Score and Short-Term Outcomes in Asphyxiated Newborns Treated With Therapeutic Hypothermia ', Pediatric Neurology, vol. 60, pp. 49-53 . https://doi.org/10.1016/j.pediatrneurol.2016.03.014
ISSN: 0887-8994
DOI: 10.1016/j.pediatrneurol.2016.03.014
Popis: BACKGROUND: The Thompson encephalopathy score is a clinical score to assess newborns suffering from perinatal asphyxia. Previous studies revealed a high sensitivity and specificity of the Thompson encephalopathy score for adverse outcomes (death or severe disability). Because the Thompson encephalopathy score was developed before the use of therapeutic hypothermia, its value was reassessed. OBJECTIVE: The purpose of this study was to assess the association of the Thompson encephalopathy score with adverse short-term outcomes, defined as death before discharge, development of severe epilepsy, or the presence of multiple organ failure in asphyxiated newborns undergoing therapeutic hypothermia. METHODS: The study period ranged from November 2010 to October 2014. A total of 12 tertiary neonatal intensive care units participated. Demographic and clinical data were collected from the "PharmaCool" multicenter study, an observational cohort study analyzing pharmacokinetics of medication during therapeutic hypothermia. With multiple logistic regression analyses the association of the Thompson encephalopathy scores with outcomes was studied. RESULTS: Data of 142 newborns were analyzed (male: 86; female: 56). Median Thompson score was 9 (interquartile range: 8 to 12). Median gestational age was 40 weeks (inter quartile range 38 to 41), mean birth weight was 3362 grams (standard deviation: 605). All newborns manifested perinatal asphyxia and underwent therapeutic hypothermia. Death before discharge occurred in 23.9% and severe epilepsy in 21.1% of the cases. In total, 59.2% of the patients had multiple organ failure. The Thompson encephalopathy score was not associated with multiple organ failure, but a Thompson encephalopathy score >= 12 was associated with death before discharge (odds ratio: 3.9; confidence interval: 1.3 to 11.2) and with development of severe epilepsy (odds ratio: 8.4; confidence interval: 2.5 to 27.8). CONCLUSION: The Thompson encephalopathy score is a useful clinical tool, even in cooled asphyxiated newborns. A score >= 12 is associated with adverse outcomes (death before discharge and development of severe epilepsy). The Thompson encephalopathy score is not associated with the development of multiple organ failure.
Databáze: OpenAIRE
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