Abstract Objective To study the value of Silverman-Anderson score versus Downes score in predicting respiratory failure in full-term neonates. Methods The convenience sampling method was used to select the full-term neonates with lung diseases who were hospitalized in the neonatal intensive care unit from July 2020 to July 2021. According to the diagnostic criteria for neonatal respiratory failure, they were divided into a respiratory failure group (65 neonates) and a non-respiratory failure group (363 neonates). Silverman-Anderson score and Downes score were used for evaluation. The receiver operating characteristic analysis was used to compare the value of the two noninvasive scores in predicting respiratory failure in full-term neonates. Results Among the 428 full-term neonates, 65 (15.2%) had respiratory failure. The Silverman-Anderson score had a significantly shorter average time spent on evaluation than the Downes score [(90±8) seconds vs (150±13) seconds; P<0.001]. The respiratory failure group had significantly higher points in both the Silverman-Anderson and Downes scores than the non-respiratory failure group (P<0.001). The Silverman-Anderson score had an AUC of 0.876 for predicting respiratory failure, with a sensitivity of 0.908, a specificity of 0.694, and a Youden index of 0.602 at the optimal cut-off value of 4.50 points. The Downes score had an AUC of 0.918 for predicting respiratory failure, with a sensitivity of 0.723, a specificity of 0.953, and a Youden index of 0.676 at the optimal cut-off value of 6.00 points. The Downes score had significantly higher AUC for predicting respiratory failure than the Silverman-Anderson score (P=0.026). Conclusions Both Silverman-Anderson and Downes scores can predict the risk of respiratory failure in full-term neonates. The Silverman-Anderson score requires a shorter time for evaluation, while the Downes score has higher prediction efficiency. It is recommended to use Downes score with higher prediction efficiency in general evaluation, and the Silverman-Anderson score requiring a shorter time for evaluation can be used in emergency.
ZHAO Yan-Hong,LIU Ya-Juan,ZHAO Xiao-Li et al. Application of two noninvasive scores in predicting the risk of respiratory failure in full-term neonates: a comparative analysis[J]. CJCP, 2022, 24(4): 423-427.
ZHAO Yan-Hong,LIU Ya-Juan,ZHAO Xiao-Li et al. Application of two noninvasive scores in predicting the risk of respiratory failure in full-term neonates: a comparative analysis[J]. CJCP, 2022, 24(4): 423-427.
Lillie J, Boot L, Speggiorin S, et al. Factors behind decline of venovenous extracorporeal membrane oxygenation to support neonatal respiratory failure[J]. Pediatr Crit Care Med, 2020, 21(8): e502-e504. PMID: 32195900. DOI: 10.1097/PCC.0000000000002340.
Zhang L, Qiu Y, Yi B, et al. Mortality of neonatal respiratory failure from Chinese northwest NICU network[J]. J Matern Fetal Neonatal Med, 2017, 30(17): 2105-2111. PMID: 27651118. DOI: 10.1080/14767058.2016.1238894.
Silverman WA, Andersen DH. A controlled clinical trial of effects of water mist on obstructive respiratory signs, death rate and necropsy findings among premature infants[J]. Pediatrics, 1956, 17(1): 1-10. PMID: 13353856.
Downes JJ, Vidyasagar D, Boggs TR, et al. Respiratory distress syndrome of newborn infants. I. New clinical scoring system (RDS score) with acid-base and blood-gas correlations[J]. Clin Pediatr (Phila), 1970, 9(6): 325-331. PMID: 5419441. DOI: 10.1177/000992287000900607.
Murki S, Singh J, Khant C, et al. High-flow nasal cannula versus nasal continuous positive airway pressure for primary respiratory support in preterm infants with respiratory distress: a randomized controlled trial[J]. Neonatology, 2018, 113(3): 235-241. PMID: 29393237. DOI: 10.1159/000484400.
Macooie AA, Fakour Z, Roanaghi P. Comparative evaluation of the effects of BLES and Survanta on treatment of respiratory distress syndrome in newborns[J]. J Family Med Prim Care, 2018, 7(5): 1063-1067. PMID: 30598958. PMCID: PMC6259541. DOI: 10.4103/jfmpc.jfmpc_188_17.
