Richardson score predicts short-term adverse respiratory outcomes in newborns ≤34 weeks gestation

Objectives To develop a model to predict which newborns greater than or equal to 34 weeks gestation with respiratory distress will die or will require prolonged (>3 days) assisted ventilation. Methods Retrospective cohort study using data from Northern California newborns greater than or equal to34 weeks gestation who presented with respiratory distress. We split the cohort into derivation and validation datasets. Bivariate and multivariate data, analyses were performed on the derivation dataset. After developing a simple score on the derivation dataset, we applied it to the original as well as to a second validation dataset from Massachusetts. Results Of 2276 babies who met our initial eligibility criteria, 203 (9.3%) had the primary study outcome (assisted ventilation >3 days or death). A simple score based on gestational age, the lowest PaO2/FIO2, a variable combining lowest pH and highest PaCO2, and the lowest mean arterial blood pressure had excellent performance, with a c-statistic of 0.85 in the derivation dataset, 0.80 in the validation dataset, and 0.80 in the secondary validation dataset. Conclusions A simple objective score based on routinely collected physiologic predictors can predict respiratory outcomes in infants greater than or equal to34 weeks gestation with respiratory distress.